Gastroesophageal reflux disease in children and adolescents in primary care

Abstract

Objectives. To determine the prevalence and incidence of a diagnosis of gastroesophageal reflux disease (GERD) in children and adolescents in UK primary care, and to assess comorbidities that are associated with a diagnosis of GERD. Material and methods. Incident GERD cases during 2000–05 were identified from The Health Improvement Network (THIN) UK primary care database via a computer search for diagnostic codes for GERD, followed by manual review of the patient records. Results. We identified 1700 children with a first diagnosis of GERD during 2000–05. The incidence of GERD was 0.84 per 1000 person-years. The incidence decreased with age from 1.48 per 1000 person-years among 1-year-old children until the age of 12 years, whereupon it increased to a maximum at 16–17 years of 2.26 per 1000 person-years for girls and 1.75 per 1000 person-years for boys. Pregnant adolescents were not included in the study. In addition to typical GERD symptoms (epigastric pain, heartburn, reflux, regurgitation), 21.2% of children reported nausea or vomiting. Children with neurological disorders were at increased risk of a GERD diagnosis. Hiatus hernia and congenital esophageal disorders were also associated with a diagnosis of GERD. Children and adolescents using antiepileptics, oral/inhaled steroids, β-agonists and paracetamol had an increased risk of a GERD diagnosis. Conclusions. The incidence of a GERD diagnosis was age-dependent and was highest among very young children and older female adolescents. Children with neurological impairments and other comorbidities were at increased risk of a GERD diagnosis.

Key Words::

• Epidemiology
• gastroesophageal reflux disease
• pediatric
• primary care

Acknowledgements

We thank Dr Anja Becher, Dr Catriona Turnbull and Dr Catherine Hill from Oxford PharmaGenesis^™ Limited, who provided writing and editorial assistance funded by AstraZeneca R&D, Mölndal, Sweden. The study was funded in part by AstraZeneca R&D, Mölndal, Sweden. A. R. and L. A. G. R. work for CEIFE, which has received research funding from AstraZeneca. S. J. and P. L. are employees of AstraZeneca. M.-A. W. was an employee of AstraZeneca at the time the study was conducted.