Skip to main content
Top
Published in: International Urology and Nephrology 2/2012

01-04-2012 | Urology – Original Paper

Concomitant vesicoureteral reflux and gastroesophageal reflux: an analytic cross-sectional study

Authors: Aydin H. Pooli, Shima Aran, Amir Reza Farhoud, Lila Saidian, Abdol-Mohammad Kajbafzadeh

Published in: International Urology and Nephrology | Issue 2/2012

Login to get access

Abstract

Purpose

Vesicoureteral reflux (VUR) and Gastroesophageal reflux (GER) are both common disorders in children and could be associated with significant morbidities. Although they appear to be separate entities, their natural history and underlying pathophysiology are the same and they both tend to resolve over time. We aimed to appraise their concurrent occurrence and prevalence of GER in VUR patients to understand whether they can be considered different manifestations of a syndrome mainly caused by developmental delay resulting in dysfunction of the sphincters.

Methods

Totally, 174 children ≤2 years of age were enrolled and 87 of them with primary VUR constituted patients group. The rest of the cases with the same age and sex distribution entered control group. All the study population underwent ultrasonographic evaluation to detect GER.

Results

GER was more frequent in patients with primary VUR. GER was more prevalent in higher grades of VUR. We observed higher prevalence of GER and higher grades of VUR in younger infants demonstrating the tendency of both conditions to resolve overtime. Bilateral VUR was more prevalent among patients with higher grades of VUR. GER was more prevalent in patients with bilateral VUR and Prevalence of bilateral VUR decreased with increase in age. These findings show that the chance of concomitant GER and VUR is higher in children with more severe developmental defect of sphincters.

Conclusions

Regarding the higher prevalence of GER among VUR patients and correlation of VUR severity with co-occurrence of GER, besides the natural tendency of both conditions to resolve overtime, they may be considered parts of developmental delay syndrome of sphincters.
Literature
1.
go back to reference Cooper CS (2009) Diagnosis and management of vesicoureteral reflux in children. Nat Rev Urol 6(9):481–489PubMedCrossRef Cooper CS (2009) Diagnosis and management of vesicoureteral reflux in children. Nat Rev Urol 6(9):481–489PubMedCrossRef
2.
go back to reference Murer L, Benetti E, Artifoni L (2007) Embryology and genetics of primary vesico-ureteric reflux and associated renal dysplasia. Pediatr Nephrol 22(6):788–797PubMedCrossRef Murer L, Benetti E, Artifoni L (2007) Embryology and genetics of primary vesico-ureteric reflux and associated renal dysplasia. Pediatr Nephrol 22(6):788–797PubMedCrossRef
3.
go back to reference Murawski IJ, Gupta IR (2006) Vesicoureteric reflux and renal malformations: a developmental problem. Clin Genet 69(2):105–117PubMedCrossRef Murawski IJ, Gupta IR (2006) Vesicoureteric reflux and renal malformations: a developmental problem. Clin Genet 69(2):105–117PubMedCrossRef
4.
go back to reference Eccles MR, Bailey RR, Abbott GD, Sullivan MJ (1996) Unravelling the genetics of vesicoureteric reflux: a common familial disorder. Hum Mol Genet 5 Spec No:1425–1429 Eccles MR, Bailey RR, Abbott GD, Sullivan MJ (1996) Unravelling the genetics of vesicoureteric reflux: a common familial disorder. Hum Mol Genet 5 Spec No:1425–1429
5.
go back to reference Eccles MR, Jacobs GH (2000) The genetics of primary vesico-ureteric reflux. Ann Acad Med Singapore 29(3):337–345PubMed Eccles MR, Jacobs GH (2000) The genetics of primary vesico-ureteric reflux. Ann Acad Med Singapore 29(3):337–345PubMed
6.
go back to reference Omari TI, Barnett CP, Benninga MA, Lontis R, Goodchild L, Haslam RR, Dent J, Davidson GP (2002) Mechanisms of gastro-oesophageal reflux in preterm and term infants with reflux disease. Gut 51(4):475–479PubMedCrossRef Omari TI, Barnett CP, Benninga MA, Lontis R, Goodchild L, Haslam RR, Dent J, Davidson GP (2002) Mechanisms of gastro-oesophageal reflux in preterm and term infants with reflux disease. Gut 51(4):475–479PubMedCrossRef
7.
8.
go back to reference Davidson G (2003) The role of lower esophageal sphincter function and dysmotility in gastroesophageal reflux in premature infants and in the first year of life. J Pediatr Gastroenterol Nutr 37(Suppl 1):S17–S22PubMed Davidson G (2003) The role of lower esophageal sphincter function and dysmotility in gastroesophageal reflux in premature infants and in the first year of life. J Pediatr Gastroenterol Nutr 37(Suppl 1):S17–S22PubMed
10.
go back to reference Gomes H, Menanteau B (1991) Gastro-esophageal reflux: comparative study between sonography and pH monitoring. Pediatr Radiol 21(3):168–174PubMedCrossRef Gomes H, Menanteau B (1991) Gastro-esophageal reflux: comparative study between sonography and pH monitoring. Pediatr Radiol 21(3):168–174PubMedCrossRef
11.
go back to reference Lazzari R, Collina A, Pession A, Corvaglia L, Tani G, Sciutti R (1991) The diagnosis of gastroesophageal reflux in childhood: a comparison between echography and pH measurement. Pediatr Med Chir 13(6):617–619PubMed Lazzari R, Collina A, Pession A, Corvaglia L, Tani G, Sciutti R (1991) The diagnosis of gastroesophageal reflux in childhood: a comparison between echography and pH measurement. Pediatr Med Chir 13(6):617–619PubMed
12.
go back to reference Jang HS, Lee JS, Lim GY, Choi BG, Choi GH, Park SH (2001) Correlation of color Doppler sonographic findings with pH measurements in gastroesophageal reflux in children. J Clin Ultrasound 29(4):212–217PubMedCrossRef Jang HS, Lee JS, Lim GY, Choi BG, Choi GH, Park SH (2001) Correlation of color Doppler sonographic findings with pH measurements in gastroesophageal reflux in children. J Clin Ultrasound 29(4):212–217PubMedCrossRef
13.
go back to reference Mazzoleni S, Drigo P, Da Dalt L, Battistella PA, Casara GL, Donzelli F, Zacchello F (1991) Gastroesophageal reflux and infantile cerebral palsy: our experience and review of the literature. Pediatr Med Chir 13(3):293–296PubMed Mazzoleni S, Drigo P, Da Dalt L, Battistella PA, Casara GL, Donzelli F, Zacchello F (1991) Gastroesophageal reflux and infantile cerebral palsy: our experience and review of the literature. Pediatr Med Chir 13(3):293–296PubMed
14.
go back to reference Spiroglou K, Xinias I, Karatzas N, Karatza E, Arsos G, Panteliadis C (2004) Gastric emptying in children with cerebral palsy and gastroesophageal reflux. Pediatr Neurol 31(3):177–182PubMedCrossRef Spiroglou K, Xinias I, Karatzas N, Karatza E, Arsos G, Panteliadis C (2004) Gastric emptying in children with cerebral palsy and gastroesophageal reflux. Pediatr Neurol 31(3):177–182PubMedCrossRef
15.
go back to reference Gangil A, Patwari AK, Bajaj P, Kashyap R, Anand VK (2001) Gastroesophageal reflux disease in children with cerebral palsy. Indian Pediatr 8(7):766–770 Gangil A, Patwari AK, Bajaj P, Kashyap R, Anand VK (2001) Gastroesophageal reflux disease in children with cerebral palsy. Indian Pediatr 8(7):766–770
16.
go back to reference Macedo M, Martins JL, Freitas Filho LG (2004) Sacral ratio and fecal continence in children with anorectal malformations. BJU Int 94(6):893–894PubMedCrossRef Macedo M, Martins JL, Freitas Filho LG (2004) Sacral ratio and fecal continence in children with anorectal malformations. BJU Int 94(6):893–894PubMedCrossRef
17.
go back to reference Boemers TM, van Gool JD, de Jong TP, Bax KM (1994) Urodynamic evaluation of children with caudal regression syndrome (Caudal dysplasia sequence). J Urol 151(4):1038–1040PubMed Boemers TM, van Gool JD, de Jong TP, Bax KM (1994) Urodynamic evaluation of children with caudal regression syndrome (Caudal dysplasia sequence). J Urol 151(4):1038–1040PubMed
18.
go back to reference Kajbafzadeh AM, Rasuli N (2001) Correlation between the sacral ratio and the outcome of VUR. BJU Int; 87(Suppl. 1):61 Kajbafzadeh AM, Rasuli N (2001) Correlation between the sacral ratio and the outcome of VUR. BJU Int; 87(Suppl. 1):61
19.
go back to reference Peña A (1995) Anorectal malformations. Semin Pediatr Surg 4(1):35–47PubMed Peña A (1995) Anorectal malformations. Semin Pediatr Surg 4(1):35–47PubMed
20.
go back to reference Baquedano P, Nardiello A, Orellana P, Díaz M, Lagomarsino E (2008) [Chronological age for the spontaneous resolution of vesicoureteral reflux][Chronological age for the spontaneous resolution of vesicoureteral reflux]. Arch Esp Urol 61(8):867–872PubMedCrossRef Baquedano P, Nardiello A, Orellana P, Díaz M, Lagomarsino E (2008) [Chronological age for the spontaneous resolution of vesicoureteral reflux][Chronological age for the spontaneous resolution of vesicoureteral reflux]. Arch Esp Urol 61(8):867–872PubMedCrossRef
21.
go back to reference Chand DH, Rhoades T, Poe SA, Kraus S, Strife CF (2003) Incidence and severity of vesicoureteral reflux in children related to age, gender, race and diagnosis. J Urol 170(4 Pt 2):1548–1550PubMedCrossRef Chand DH, Rhoades T, Poe SA, Kraus S, Strife CF (2003) Incidence and severity of vesicoureteral reflux in children related to age, gender, race and diagnosis. J Urol 170(4 Pt 2):1548–1550PubMedCrossRef
22.
go back to reference Connolly LP, Zurakowski D, Connolly SA, Peters CA, Drubach LA, Cilento BG Jr, Treves ST (2001) Natural history of vesicoureteral reflux in girls after age 5 years. J Urol 166(6):2359–2363PubMedCrossRef Connolly LP, Zurakowski D, Connolly SA, Peters CA, Drubach LA, Cilento BG Jr, Treves ST (2001) Natural history of vesicoureteral reflux in girls after age 5 years. J Urol 166(6):2359–2363PubMedCrossRef
23.
go back to reference Marino AJ, Assing E, Carbone MT, Hiatt IM, Hegyi T, Graff M (1995) The incidence of gastroesophageal reflux in preterm infants. J Perinatol 15(5):369–371PubMed Marino AJ, Assing E, Carbone MT, Hiatt IM, Hegyi T, Graff M (1995) The incidence of gastroesophageal reflux in preterm infants. J Perinatol 15(5):369–371PubMed
24.
go back to reference Osatakul S, Sriplung H, Puetpaiboon A, Junjana CO, Chamnongpakdi S (2002) Prevalence and natural course of gastroesophageal reflux symptoms: a 1-year cohort study in Thai infants. J Pediatr Gastroenterol Nutr 34(1):63–67PubMedCrossRef Osatakul S, Sriplung H, Puetpaiboon A, Junjana CO, Chamnongpakdi S (2002) Prevalence and natural course of gastroesophageal reflux symptoms: a 1-year cohort study in Thai infants. J Pediatr Gastroenterol Nutr 34(1):63–67PubMedCrossRef
25.
go back to reference Roberts JA, Riopelle AJ (1977) Vesicoureteral reflux in the primate: II Maturation of the ureterovesical junction. Pediatrics 59(4):566–568PubMed Roberts JA, Riopelle AJ (1977) Vesicoureteral reflux in the primate: II Maturation of the ureterovesical junction. Pediatrics 59(4):566–568PubMed
26.
go back to reference Elder JS, Peters CA, Arant BS Jr, Ewalt DH, Hawtrey CE, Hurwitz RS, Parrott TS, Snyder HM 3rd, Weiss RA, Woolf SH, Hasselblad V (1997) Pediatric vesicoureteral reflux guidelines panel summary report on the management of primary vesicoureteral reflux in children. J Urol 157(5):1846–1851PubMedCrossRef Elder JS, Peters CA, Arant BS Jr, Ewalt DH, Hawtrey CE, Hurwitz RS, Parrott TS, Snyder HM 3rd, Weiss RA, Woolf SH, Hasselblad V (1997) Pediatric vesicoureteral reflux guidelines panel summary report on the management of primary vesicoureteral reflux in children. J Urol 157(5):1846–1851PubMedCrossRef
27.
go back to reference Campbell MF, Wein AJ, Kavoussi LR (2007) Campbell-walsh urology. Alan JW, Louis RK (eds), 9th edn. W.B. Saunders, Philadelphia. 4 v. (xlii, 3945, cxv p.) Campbell MF, Wein AJ, Kavoussi LR (2007) Campbell-walsh urology. Alan JW, Louis RK (eds), 9th edn. W.B. Saunders, Philadelphia. 4 v. (xlii, 3945, cxv p.)
28.
go back to reference (1981) Medical versus surgical treatment of primary vesicoureteral reflux: report of the international reflux study committee. Pediatrics 67:392–400 (1981) Medical versus surgical treatment of primary vesicoureteral reflux: report of the international reflux study committee. Pediatrics 67:392–400
29.
go back to reference Smellie JM, Barratt TM, Chantler C, Gordon I, Prescod NP, Ransley PG, Woolf AS (2001) Medical versus surgical treatment in children with severe bilateral vesicoureteric reflux and bilateral nephropathy: a randomised trial. Lancet 357(9265):1329–1333PubMedCrossRef Smellie JM, Barratt TM, Chantler C, Gordon I, Prescod NP, Ransley PG, Woolf AS (2001) Medical versus surgical treatment in children with severe bilateral vesicoureteric reflux and bilateral nephropathy: a randomised trial. Lancet 357(9265):1329–1333PubMedCrossRef
30.
go back to reference Fanos V, Cataldi L (2004) Antibiotics or surgery for vesicoureteric reflux in children. Lancet 364(9446):1720–1722PubMedCrossRef Fanos V, Cataldi L (2004) Antibiotics or surgery for vesicoureteric reflux in children. Lancet 364(9446):1720–1722PubMedCrossRef
31.
go back to reference Olbing H, Smellie JM, Jodal U, Lax H (2003) New renal scars in children with severe VUR: a 10-year study of randomized treatment. Pediatr Nephrol 18(11):1128–1131PubMedCrossRef Olbing H, Smellie JM, Jodal U, Lax H (2003) New renal scars in children with severe VUR: a 10-year study of randomized treatment. Pediatr Nephrol 18(11):1128–1131PubMedCrossRef
32.
go back to reference Wennerström M, Hansson S, Jodal U, Stokland E (2000) Primary and acquired renal scarring in boys and girls with urinary tract infection. J Pediatr 136(1):30–34PubMedCrossRef Wennerström M, Hansson S, Jodal U, Stokland E (2000) Primary and acquired renal scarring in boys and girls with urinary tract infection. J Pediatr 136(1):30–34PubMedCrossRef
33.
go back to reference Wennerström M, Hansson S, Jodal U, Sixt R, Stokland E (2000) Renal function 16 to 26 years after the first urinary tract infection in childhood. Arch Pediatr Adolesc Med 154(4):339–345PubMed Wennerström M, Hansson S, Jodal U, Sixt R, Stokland E (2000) Renal function 16 to 26 years after the first urinary tract infection in childhood. Arch Pediatr Adolesc Med 154(4):339–345PubMed
34.
go back to reference Downs SM (1999) Technical report: urinary tract infections in febrile infants and young children. The urinary tract subcommittee of the american academy of pediatrics committee on quality improvement. Pediatrics 103(4):e54PubMedCrossRef Downs SM (1999) Technical report: urinary tract infections in febrile infants and young children. The urinary tract subcommittee of the american academy of pediatrics committee on quality improvement. Pediatrics 103(4):e54PubMedCrossRef
35.
go back to reference Capozza N, Lais A, Nappo S, Caione P (2004) The role of endoscopic treatment of vesicoureteral reflux: a 17-year experience. J Urol 172(4 Pt 2):1626–1628 discussion 1629PubMedCrossRef Capozza N, Lais A, Nappo S, Caione P (2004) The role of endoscopic treatment of vesicoureteral reflux: a 17-year experience. J Urol 172(4 Pt 2):1626–1628 discussion 1629PubMedCrossRef
36.
go back to reference (1999) Practice parameter: the diagnosis, treatment, and evaluation of the initial urinary tract infection in febrile infants and young children. American Academy of Pediatrics. Committee on Quality Improvement. Subcommittee On Urinary Tract Infection. Pediatrics 103(4 Pt 1):843–852 (1999) Practice parameter: the diagnosis, treatment, and evaluation of the initial urinary tract infection in febrile infants and young children. American Academy of Pediatrics. Committee on Quality Improvement. Subcommittee On Urinary Tract Infection. Pediatrics 103(4 Pt 1):843–852
38.
go back to reference Wennerström M, Hansson S, Jodal U, Stokland E (1998) Disappearance of vesicoureteral reflux in children. Arch Pediatr Adolesc Med 152(9):879–883PubMed Wennerström M, Hansson S, Jodal U, Stokland E (1998) Disappearance of vesicoureteral reflux in children. Arch Pediatr Adolesc Med 152(9):879–883PubMed
39.
go back to reference Smellie JM, Jodal U, Lax H, Möbius TT, Hirche H, Olbing H, Writing Committee, International Reflux Study in Children (European Branch) (2001) Outcome at 10 years of severe vesicoureteric reflux managed medically: report of the international reflux study in children. J Pediatr 139(5):656–663PubMedCrossRef Smellie JM, Jodal U, Lax H, Möbius TT, Hirche H, Olbing H, Writing Committee, International Reflux Study in Children (European Branch) (2001) Outcome at 10 years of severe vesicoureteric reflux managed medically: report of the international reflux study in children. J Pediatr 139(5):656–663PubMedCrossRef
40.
go back to reference Esbjörner E, Hansson S, Jakobsson B, Swedish Paediatric Nephrology Association (2004) Management of children with dilating vesico-ureteric reflux in Sweden. Acta Paediatr 93(1):37–42PubMedCrossRef Esbjörner E, Hansson S, Jakobsson B, Swedish Paediatric Nephrology Association (2004) Management of children with dilating vesico-ureteric reflux in Sweden. Acta Paediatr 93(1):37–42PubMedCrossRef
41.
go back to reference Tamminen-Möbius T, Brunier E, Ebel KD, Lebowitz R, Olbing H, Seppänen U, Sixt R (1992) Cessation of vesicoureteral reflux for 5 years in infants and children allocated to medical treatment. The international reflux study in children. J Urol 148(5 Pt 2):1662–1666PubMed Tamminen-Möbius T, Brunier E, Ebel KD, Lebowitz R, Olbing H, Seppänen U, Sixt R (1992) Cessation of vesicoureteral reflux for 5 years in infants and children allocated to medical treatment. The international reflux study in children. J Urol 148(5 Pt 2):1662–1666PubMed
42.
go back to reference Riccabona M, Maurer U, Lackner H, Uray E, Ring E (1992) The role of sonography in the evaluation of gastro-oesophageal reflux–correlation to pH-metry. Eur J Pediatr 151(9):655–657PubMedCrossRef Riccabona M, Maurer U, Lackner H, Uray E, Ring E (1992) The role of sonography in the evaluation of gastro-oesophageal reflux–correlation to pH-metry. Eur J Pediatr 151(9):655–657PubMedCrossRef
43.
go back to reference Vassiou K, Vlychou M, Moisidou R, Sioka A, Fezoulidis IV (2004) Contrast-enhanced sonographic detection of vesicoureteral reflux in children: comparison with voiding cystourethrography. Rofo 176(10):1453–1457PubMedCrossRef Vassiou K, Vlychou M, Moisidou R, Sioka A, Fezoulidis IV (2004) Contrast-enhanced sonographic detection of vesicoureteral reflux in children: comparison with voiding cystourethrography. Rofo 176(10):1453–1457PubMedCrossRef
44.
go back to reference Papadaki PJ, Vlychou MK, Zavras GM, Baltas CS, Kouni SN, Poulou KE, Rapidi AC, Petropoulou K, Manavis JB (2002) Investigation of vesicoureteral reflux with colour Doppler sonography in adult patients with spinal cord injury. Eur Radiol 12(2):366–370PubMedCrossRef Papadaki PJ, Vlychou MK, Zavras GM, Baltas CS, Kouni SN, Poulou KE, Rapidi AC, Petropoulou K, Manavis JB (2002) Investigation of vesicoureteral reflux with colour Doppler sonography in adult patients with spinal cord injury. Eur Radiol 12(2):366–370PubMedCrossRef
45.
go back to reference Oak SN, Kulkarni B, Chaubal N (1999) Color flow Doppler sonography: a reliable alternative to voiding cystourethrogram in the diagnosis of vesicoureteral reflux in children. Urology 53(6):1211–1214PubMedCrossRef Oak SN, Kulkarni B, Chaubal N (1999) Color flow Doppler sonography: a reliable alternative to voiding cystourethrogram in the diagnosis of vesicoureteral reflux in children. Urology 53(6):1211–1214PubMedCrossRef
46.
go back to reference Schneider K, Jablonski C, Wiessner M, Kohn M, Fendel H (1984) Screening for vesicoureteral reflux in children using real-time sonography. Pediatr Radiol 14(6):400–403PubMedCrossRef Schneider K, Jablonski C, Wiessner M, Kohn M, Fendel H (1984) Screening for vesicoureteral reflux in children using real-time sonography. Pediatr Radiol 14(6):400–403PubMedCrossRef
Metadata
Title
Concomitant vesicoureteral reflux and gastroesophageal reflux: an analytic cross-sectional study
Authors
Aydin H. Pooli
Shima Aran
Amir Reza Farhoud
Lila Saidian
Abdol-Mohammad Kajbafzadeh
Publication date
01-04-2012
Publisher
Springer Netherlands
Published in
International Urology and Nephrology / Issue 2/2012
Print ISSN: 0301-1623
Electronic ISSN: 1573-2584
DOI
https://doi.org/10.1007/s11255-011-0021-z

Other articles of this Issue 2/2012

International Urology and Nephrology 2/2012 Go to the issue
Live Webinar | 27-06-2024 | 18:00 (CEST)

Keynote webinar | Spotlight on medication adherence

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.

Prof. Kevin Dolgin
Prof. Florian Limbourg
Prof. Anoop Chauhan
Developed by: Springer Medicine
Obesity Clinical Trial Summary

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine