Prevalence and natural course of gastroesophageal reflux symptoms :
A one-year cohort study in Thai infants
โครงการอุบัติการณ์และการดำเนินโรคของอาการ gastroesophageal reflux ในทารกไทย
Seksit Osatakul, Assoc. Prof., D. of Pediatrics, F. of Medicine, PSU.
Hutcha Sriplung, Assoc. Prof., D. of Pathology, F. of Medicine, PSU.
Areeruk Puetpaiboon, Scientist, D. of Pediatrics, F. of Medicine, PSU.
Cha-on Junjana, Nutritionist, D. of Pediatrics, F. of Medicine, PSU.
Suthaporn Chamnongpakdi, Nutritionist, D. of Pediatrics, F. of Medicine, PSU.
Corresponding e-mail : oseksit@ratree.psu.ac.th
Grant : Government Budget
Published : Research Report
Key words : Thai infants, gastroesophageal reflux, epidemiological studies, infants
Background : Epidemiological studies in adults suggest that the nature of gastroesophageal reflux may be different among various ethnic groups. Until recently, there has been limited informa-tion concerning the epidemiology of gastroesophageal reflux in non-Western children. The objectives of this cohort study were to investigate the prevalence of gastroesophageal reflux in Thai infants and to describe the clinical course of reflux regurgitation during the first year of life.
Methods : A cohort study was carried out in 216 healthy neonates who attended the well-baby clinic Songklanagarind Hospital between March-June 1998. All neonates were followed up, at regular well-baby clinic visits, for one year for reflux symptoms and clinical progress. Information concern-ing gastroesophageal reflux symptoms was obtained by interviewing the parents and from their diary records. An infant who regurgitated at least one day per week was considered to have gastroesopha-geal reflux.
Results : Of 145 infants who had completed a one-year cohort, the prevalence of gastroeso-phageal reflux peaked at 2 months with 86.9% and significantly decreased to 69.7%, 45.5% and
22.8% between 4, 6 and 8 months, respectively. At one year of age, only 7.6% of infants still had
reflux regurgitation. Most Thai infants with gastroesophageal reflux had mild symptoms : 90% of
them regurgitated only 1-3 times per day and daily regurgitation was reported in a low percentage. There was no significant difference in prevalence of gastroesophageal reflux between breast-fed and bottle-fed infants. Comparing betwen infants with gastroesophageal reflux and those without, the standard deviation scores of body weight for age were similar. No pathologic gastroesophageal reflux was observed during this study period.
Conclusions : The nature of gastroesophageal reflux in Thai infants differs from that of
Western infants. The prevalence of gastroesophageal reflux in Thai infants was very high in the pe-
riod of 1-2 months of age, however, many infants became symptom-free by 6 months. The type of feeding (breast milk vs bottle milk) had no influence on the prevalence of gastroesophageal reflux.
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