A Trial of Comprehensive Treatment for Recurrent Respiratory Infections accompanied with Gastroesophageal Reflux and Swallowing Incoordination

Comprehensive treatment, including pharmacotherapy, physiotherapy, guidance as to swallowing exercise, and surgical treatment, was given to the children with recurrent respiratory infections accompanied with gastroesophageal reflux (GER) or swallowing incoordination, and the effect of the treatment was investigated. The subjects were 14 children, the outpatients or inpatients of Gunma Children's Medical Center, who were suffering from recurrent respiratory infections accompanied with GER or swallowing incoordination. Of these cases, 7 were accompanied only with GER, 3 were accompanied only with swallowing incoordination, and the remaining 4 cases were accompanied with both of them. Diagnoses were made based on the results of upper gastrointestinal series, fiberoptic laryngoscopy, gastroesophageal scintigraphy, 24-hours pH monitoring, measurement of esophageal pressure, gastroesophageal endoscopy. As to the treatment of swallowing incoordination, the training of eating exercise was carried out after due consideration of the way of eating, the menus of meals, etc. for each case, by doctors, nurses, physiotherapists and dietitians. To the family of each patient, guidance was actively given by means of newly prepared pamphlets and other materials. As to the treatment of GER, postural therapy, as well as pharmacotherapy using antacids, drugs for improving the digestive tract function, etc. were conducted. To the refractory cases, surgical treatment was given. The frequency of recurrence of recurrent respiratory infections has decreased in 13 of the 14 cases. For the treatment of recurrent respiratory infections accompanied with GER or swallowing incoordination, it was considered to be necessary to establish a comprehensive treatment system including doctors, nurses, physiotherapists and dietitians.