Allergic rhinitis as a key factor for the development of gastroesophageal reflux disease in children

Ming-Chu Feng; Yi-Giien Tsai; Yu-Han Chang; Chao-Hung Kuo; Yi-Ching Lin; Chih-Hsing Hung

doi:10.1016/j.jmii.2020.08.008

Allergic rhinitis as a key factor for the development of gastroesophageal reflux disease in children

J Microbiol Immunol Infect. 2021 Dec;54(6):1167-1174. doi: 10.1016/j.jmii.2020.08.008. Epub 2020 Aug 18.

Authors

Ming-Chu Feng¹, Yi-Giien Tsai², Yu-Han Chang³, Chao-Hung Kuo⁴, Yi-Ching Lin⁵, Chih-Hsing Hung⁶

Affiliations

¹ Department of Nursing, Kaohsiung Municipal Siaogang Hospital, Kaohsiung, Taiwan, ROC; School of Nursing, Fooyin University, Kaohsiung, Taiwan, ROC.
² Department of Pediatrics, Changhua Christian Children Hospital, Changhua, Taiwan, ROC; School of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan, ROC; School of Medicine, Chung Shan Medical University, Taichung, Taiwan, ROC.
³ Teaching and Research Center of Kaohsiung Municipal Siaogang Hospital, Kaohsiung, Taiwan, ROC.
⁴ Department of Internal Medicine, Kaohsiung Municipal Siaogang Hospital, Kaohsiung, Taiwan, ROC; Division of Gastroenterology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan, ROC; Department of Medicine, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan, ROC.
⁵ Department of Laboratory Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan, ROC; Department of Laboratory Medicine, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan, ROC; Ph.D. Program in Toxicology, College of Pharmacy, Kaohsiung Medical University, Kaohsiung, Taiwan, ROC; Substance and Behavior Addiction Research Center, Kaohsiung Medical University, Kaohsiung, Taiwan, ROC; Department of Pediatrics, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan, ROC. Electronic address: winterjeanne@gmail.com.
⁶ Department of Pediatrics, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan, ROC; Research Center for Environmental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan, ROC; Department of Pediatrics, Faculty of Pediatrics, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan, ROC; Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan, ROC; Department of Pediatrics, Kaohsiung Municipal Siaogang Hospital, Kaohsiung, Taiwan, ROC. Electronic address: pedhung@gmail.com.

PMID: 32883617
DOI: 10.1016/j.jmii.2020.08.008

Abstract

Background: Gastroesophageal reflux disease (GERD) may cause airway symptoms and some airway diseases exacerbate GERD symptoms. Asthma and allergic rhinitis (AR) have been identified as united airway disease because of their similar epidemiology and pathophysiology. Asthma has been considered a risk factor to develop GERD. However, the association between AR and GERD is not clear. We tried to investigate whether AR could increase the development of GERD.

Methods: Children diagnosed as AR without a prior history of GERD were conducted from the National Health Insurance Research Database between 2000 and 2005. After propensity score matching, we enrolled 36,588 children with AR and 36,588 non-AR children as the controls. Cox regression models were adopted to calculate the hazard ratio (HR) of GERD.

Results: AR children had a significantly increased risk of GERD than non-AR children (adjusted HR 1.91, 95% CI = 1.73-2.11, p < 0.001), especially in the age less than 6 years old (adjusted HR 2.68, 95% CI = 1.64-4.38, p < 0.001). The risk factor related to increased risk of GERD including age, gender, and chronic sinusitis.

Conclusion: AR is a risk factor associated with the development of GERD in children.

Keywords: Allergic rhinitis (AR); Asthma; Children; Gastroesophageal reflux disease (GERD).

MeSH terms

Adolescent
Asthma / epidemiology
Child
Child, Preschool
Female
Gastroesophageal Reflux / epidemiology*
Humans
Male
National Health Programs / statistics & numerical data
Propensity Score
Proportional Hazards Models
Rhinitis, Allergic / epidemiology*
Risk Factors
Taiwan / epidemiology