LONG TERM FOLLOW-UP IN INFANTS WITH GASTROESOPHAGEAL REFLUX.:

Introduction: The time required to resolve clinical manifestations of gastro-esophageal reflux (GER) diagnosed during the first months of life is a permanent question from pediatricians and parents. To establish criteria of the possible evolution in these babies, is still a difficult problem posed to gastroenterologists. Aim: To analyze the four variables of the 24 hour pH study as possible predictors of clinical evolution. MATERIAL and METHODS: Since January 1997 up to December 2002, 205 infants (107 male-98 female) with a median age 2,9 months (r 10-150 days) were studied in a retrospective observational analysis. All of them were normal weight term infants without associated pathologic problems, with positive x-ray barium fluoroscopy with suggestive symptoms of GER (regurgitations, vomiting, irritability, recurrent respiratory manifestations) in which a 24 pH hour monitoring was performed that resulted with an abnormal score (Vandenplas). Two groups were established according to the interruption of medications because of clinical improvement. Group 1: 41 infants requiring medications beyond 18 months of age. Group 2: 164 infants stopped medications before 17 months of age. Results: In the first 24 hour pH study the following results were observed:TABLEConclusions: None of the four variables considered in the first 24 pH study was useful to establish the necessary time to stop medications because of clinical resolution of symptoms. Only 20% of these infants required treatment beyond 18 months of age. Unfortunately, there is no item per se, to help us predict longstanding evolution. Other studies are necessary to aid us with this prevalent problem.