The overlap of gastroesophageal reflux disease and functional constipation in children: the efficacy of constipation treatment

Eur J Gastroenterol Hepatol. 2017 Nov;29(11):1264-1268. doi: 10.1097/MEG.0000000000000979.


Objectives: This study was designed to investigate the frequency of gastroesophageal reflux disease (GERD) in children with functional constipation (FC). It was structured to assess the improvement level in reflux symptoms by measuring the acid reflux in these patients after they had received FC treatment.

Methods: Ninety-four children who suffered from constipation were evaluated prospectively. Data forms were completed to assess the GERD symptoms in all the cases. Twenty-four-hour pH meter monitoring was performed in 55 of the patients with GERD symptoms. The cases with abnormal acid reflux were treated by conventional therapy for FC. These cases were re-evaluated for GERD symptoms and weekly defecation frequency, and 24-h pH meter monitoring was performed at the end of a 3-month period.

Results: An abnormal level of acid reflux was determined in 23 of the 55 cases. After the constipation treatment, a significant improvement was achieved in the acid reflux index and GERD symptoms, whereas the weekly defecation frequency increased.

Conclusion: GERD is a frequent problem in children with FC. Treatment of the constipation can improve the reflux symptoms and abnormal acid reflux in these cases. Physicians should bear in mind the co-occurrence of these two prevalent problems for better disease management.

MeSH terms

  • Adolescent
  • Anorexia / etiology
  • Child
  • Child, Preschool
  • Constipation / complications*
  • Constipation / therapy*
  • Defecation*
  • Eructation / etiology
  • Esophageal pH Monitoring
  • Female
  • Gastroesophageal Reflux / complications*
  • Heartburn / etiology
  • Hiccup / etiology
  • Hoarseness / etiology
  • Humans
  • Laryngopharyngeal Reflux / etiology
  • Male
  • Prospective Studies
  • Severity of Illness Index
  • Symptom Assessment