GERD Infant Q.pdf

pETERSHEALTHSCIENCESUBRMIY Reflux Symptoms in 100 Normal Infants: DiagnosticValidity of the Infant Gastroesophageal Reflux Questionnaire SusanR.Orenstein,M.D.I.2 Theresa M. Shalaby, R.N.2 Jeffrey F.Cohn, Ph.D.3 Summary: To identify the prevalence of reflux symptoms in normal infants, to characterize the diag- nostic validity ofa previously described I38-item Infant Gastroesophageal Reflux Questionnaire (I-GERQ) for separating normal infants from those with gastroesophageal reflux disease (G,ERD), and to identify potentially provocative c~retaking practices, we administered the qu;stionnaire to 100 infants attending a well-baby clinic (normals) and to 35 infants referred to the Gastroenterology Division for evaluation for GERD and testing positive on esophageal pH prob~ or biopsy (GERD infants). Differences were analyzed by Chi-square, and odds ratios were defined. The diagnostic validity of a 25-point I-GERQ GERD score based on 11 items on the questionnaire was evaluated by calculating its sensitivity, specificity, and positive and negative predictive values. We found that normal infants had a high prevalence of reflux symptoms, such as daily regurgitation (40%), respira- tory symptoms, crying more than an hour a day (17%), arching (10%), or daily hiccups (36%) but that many symptoms were significantly more prevalent in the GERD than in the normal infants (Chi-square P.05), and odds ratios were above 3 for nearly 20 items. The positive and negative predictive values for the 25-point I-GERQscore were 1.00 and .94-.98, respectively. Environmental smoke exposure did not quite reach significance as a provocative factor for GERD. Although normal infants have a high prevalence of symptoms suggesting GERD, a simple questionnaire- based score is a valid diagnostic test with high positive and negative predictive values. Introduc