Gastroesophageal reflux in children with cerebral palsy: Does symptom presence reflect disease severity?
Year: 2026
Type: article
Study design: Observational Study
Abstract: OBJECTIVES: To determine whether the presence of gastroesophageal reflux symptoms in children with cerebral palsy (CP) reflects pathological reflux severity as assessed by 24-h multichannel intraluminal impedance-pH monitoring (MII-pH). METHODS: We conducted a multicenter retrospective review of MII-pH tracings in children with CP (Gross Motor Function Classification System IV-V), aged 1-15 years, evaluated before gastrostomy placement across 11 centers in Argentina, Brazil, Mexico, and Spain. Patients were classified as symptomatic or asymptomatic based on caregiver reports. Reflux index (RI), number and type of reflux episodes, acid clearance time, and mean nocturnal baseline impedance (MNBI) were compared. RESULTS: A total of 201 MII-pH tracings were included. A pathological RI (≥7%) was identified in 18.4% of patients: 23.1% of symptomatic and 12.9% of asymptomatic children (p = 0.03). No significant differences were found in total reflux episodes, acid clearance time, or MNBI. Among symptomatic children, 27% demonstrated a positive symptom-reflux correlation. Respiratory symptoms (p = 0.009), regurgitation (p < 0.001), and rumination (p = 0.005) were associated with reflux events, while most symptoms showed no association. CONCLUSIONS: Children with CP can have abnormal RI in the absence of symptoms. Symptoms do not reliably indicate abnormal acid exposure. These findings highlight the limitations of symptom-based diagnosis and reinforce the value of objective assessment with MII-pH monitoring.
DOI: 10.1002/jpn3.70606
Authors: Cristina Lorenzo, Cecilia Zubiri, Anabella Zosi, Sandro Miculan, Daniela Neder, Ana Rocca, Judith Cohen Sabban, Roman Bigliardi, Maria Florencia Biasoli, Manuela Manterola, Maria de los Angeles Savia, Luis Orlando Perez, Carlos Ruiz Hernández, Renata Weinschelbaum, Ana Cristina Fontenele Soares, Soraia Tahan, Veronica Plante, Christian Boggio Marzet, Soledad Arcucci, Erick Toro‐Monjaraz, Maria Alejandra Mortarini, Samantha Arrizabalo, Miguel Saps
Institutions: Hospital de Niños Superiora Sor María Ludovica, Garrahan Hospital, Hospital Italiano de Buenos Aires, Hospital Posadas, Hospital General de Niños Ricardo Gutierrez, Hospital El Cruce, Centro Científico Tecnológico Patagónico, Hospital Sant Joan de Déu Barcelona, Universidade Federal de São Paulo, Instituto Nacional de Pediatria, Hospital Universitario Austral, University of Miami
Language: English
Subfield: Gastroenterology
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W7221601910