Four cases of otitis-prone children with gastroesophageal reflux disease

Abstract

  The major causes of recurrent otitis media are considered to be 1) the immunological immaturity of infants, 2) an increase in the prevalence of multidrug-resistant bacteria, and 3) changes in the social and family environment. In addition, gastroesophageal reflux disease (GERD) should be considered as an additional possible cause of intractable recurrent otitis media.
  We encountered four cases of otitis-prone children with GERD. In these cases, it was extremely difficult to treat the otitis media, as the patients had taken antibacterial drugs for a long time in addition to undergoing surgical treatments, including tympanostomy and insertion of ventilation tubes. Furthermore, three of the patients had associated respiratory tract symptoms that were difficult to treat. It was possible to diagnose GERD by combining 24-hour esophageal pH monitoring, upper esophagography, and esophageal scintigraphy.
  The main treatment methods are educating the parents on GERD and daily nutritional guidance. H2 receptor antagonists and mosapride citrate are prescribed. However, these treatments have not been sufficiently effective at our hospital.