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A Case of Chronic Recurrent Obstructive Bronchitis Associated with Gastro-Esophageal Reflux

Journal of the Korean Pediatric Society 1992;35(4):556-562.
Published online April 15, 1992.
A Case of Chronic Recurrent Obstructive Bronchitis Associated with Gastro-Esophageal Reflux
Myung Hee Min, Sang Soo Roh, Sang Il Lee, Sang Woo Kim
Department of Pediatrics, College of Medicine, Inje University, Seoul, Korea
위식도역류에 의한 만성 재발성 폐색성 기관지염 1례
민명희, 노상수, 이상일, 김상우
인제대학교 의과대학 서울백병원 소아과학교실
It has been well established that the gastroesophageal reflux and chronic respiratory problem were closely related. Several reports in pediatric literature have implicated the aspiration of gasrtric contents as a trigger factor of cough, wheezing, and recurrent pulmonary disease. Several possible mechanisms have been proposed whereby acidic gastric content can trigger bronchospasm and, in turn, bronchospams can trigger gastroesopohageal reflux. Several tests, including radioisotope scintiscan and esophageal acid monitoring and manometry, have been tried to detect of gastroesophageal reflux, but esophageal reflux has remained as a difficult clinical diagnosis to establish. Therefore, gastroesophageal reflux should be considered as a possible cause or contributing factor in any child with severe asthma or recurrent pneumonias or both. We experienced a 5-year-old boy who suffered from recurrent pneumonia and wheezing for three years after the esophageal reconstruction surgery. He took barium esophagogram 3 times and radioisotope scintiscan twice. These revealed no remarkable reflux but his esophageal motility and clearance were markedly delayed. Respiratory symptoms were not improved with the conventional treatment at the beginning. After the combination of antireflux therapy, those symptoms had been subsided and he became quite normal.
Key Words: Gastroesophageal reflux, Recurrent pneumonia, Refractory asthma

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