Role of reflux in the etiology of otitis media with effusion in children

| Posted in: Science

Journal name: World Journal of Pharmaceutical Research
Original article title: Role of reflux in the etiology of otitis media with effusion in children
The WJPR includes peer-reviewed publications such as scientific research papers, reports, review articles, company news, thesis reports and case studies in areas of Biology, Pharmaceutical industries and Chemical technology while incorporating ancient fields of knowledge such combining Ayurveda with scientific data.
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Original source:

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Author:

Mahmoud Elbahrawy, MD and Ali Sobhi Mohamed


World Journal of Pharmaceutical Research:

(An ISO 9001:2015 Certified International Journal)

Full text available for: Role of reflux in the etiology of otitis media with effusion in children

Source type: An International Peer Reviewed Journal for Pharmaceutical and Medical and Scientific Research

Doi: 10.20959/wjpr20171-21431

Copyright (license): WJPR: All rights reserved


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Summary of article contents:

Introduction

Otitis media with effusion (OME) is a prevalent condition in children, particularly in developing countries, where it often goes unnoticed and can lead to chronic issues such as hearing impairment. The etiology of OME is multifactorial, involving various factors like viral infections, allergies, bacterial presence, and dysfunction of the Eustachian tube. An emerging area of research is the potential link between gastro-esophageal reflux disease (GERD) and OME, prompting investigations into whether reflux can affect the middle ear through mechanisms such as the presence of gastric contents in the nasopharynx.

The Role of Pepsin in OME

The study highlights the significance of detecting pepsin in middle ear effusion (MEE) as a marker for gastro-esophageal reflux. Researchers evaluated effusions from 40 children diagnosed with chronic OME and found that all samples contained pepsin in concentrations ranging from 523.25 to 1214.0 ng/ml, with an average level of 841.98 ng/ml. Notably, there was a statistically significant correlation between the level of pepsin and the degree of hearing loss in these patients, indicating that higher pepsin levels were associated with more severe hearing impairments.

Patient Background and Symptoms

The study involved children aged 3 to 8 years, with a slight male predominance among the participants. Symptoms varied widely; all patients reported a decrease in hearing, while a significant portion experienced earache, impaired speech, and school-related difficulties. Gastro-esophageal symptoms such as abdominal pain, nausea, and heartburn were also common, as well as extra-esophageal symptoms including sore throat and dry cough. The otoscopic examination showed characteristic changes in the tympanic membrane, which are indicative of chronic middle ear issues.

Implications of GERD in Otolaryngological Disorders

Recent research suggests that GER pathophysiologically contributes to various ear, nose, and throat conditions. The refluxed acid and pepsin might lead to inflammation of the Eustachian tube, causing it to malfunction and subsequently result in OME. Studies have documented shared symptoms between GERD and chronic otitis, suggesting that controlling GER may alleviate recurrent middle ear infections and related diseases in children. The findings advocate for the consideration of GERD treatment in children with chronic OME to potentially reduce the necessity for surgical interventions.

Conclusion

The presence of pepsin in MEE underscores the relevance of gastro-esophageal reflux as a contributing factor in the etiology of otitis media with effusion. The research supports utilizing pepsin levels as a reliable diagnostic marker for reflux in affected children and suggests potential therapeutic avenues aimed at managing GERD to mitigate the impact of OME. While the current study establishes a correlation between reflux and OME, further investigations are warranted to clarify the nature of this relationship and its implications for clinical management.

FAQ section (important questions/answers):

What is the purpose of this study on otitis media?

The study aims to investigate the relationship between gastro-esophageal reflux and chronic middle ear effusion by detecting pepsin levels in middle ear fluid of affected children.

How many children participated in the study, and what were their ages?

The study included 40 children aged 3 to 8 years old, with most cases observed in the 3-5 years age group.

What were the main symptoms experienced by participants in the study?

Participants primarily reported hearing loss, earache, and various gastro-esophageal symptoms like abdominal pain and difficulty swallowing.

What was the key finding regarding pepsin levels in middle ear effusions?

All effusions from participants contained pepsin, with concentrations averaging 841.98 ng/ml, indicating a link between gastro-esophageal reflux and otitis media with effusion.

What correlation was found between pepsin levels and hearing loss?

A statistically significant correlation was identified, showing that higher pepsin levels were associated with increased degrees of hearing loss in affected children.

What conclusions can be drawn regarding gastro-esophageal reflux and otitis media?

The study suggests that gastro-esophageal reflux may contribute to otitis media with effusion, supporting the need for further research and potentially anti-reflux treatment in affected children.

Glossary definitions and references:

Scientific and Ayurvedic Glossary list for “Role of reflux in the etiology of otitis media with effusion in children”. This list explains important keywords that occur in this article and links it to the glossary for a better understanding of that concept in the context of Ayurveda and other topics.

1) Disease:
Disease refers to any abnormal condition affecting the body that leads to physical or psychological dysfunction. In the study, chronic secretory otitis media is highlighted as a common condition in children, particularly in developing countries. Understanding its etiology is crucial for managing the health of affected children effectively.

2) Table:
A table serves to present data in a structured format, making it easier for readers to digest information. In the text, tables detail various statistics, such as age distribution, sex distribution, otoscopic findings, and symptom prevalence among patients, which are essential for analyzing the study's findings.

3) Study (Studying):
A study is a systematic investigation aimed at discovering new information or validating existing knowledge. The discussed research investigates the role of gastro-esophageal reflux in chronic otitis media with effusion. This study's outcomes contribute to understanding the interplay between reflux and middle ear diseases in children.

4) Male:
Male refers to the sex of an organism that typically has XY chromosomes. In the study, male children constituted a significant portion of the participants, reflecting a common observation where male children exhibit a higher incidence of otitis media due to various biological and environmental factors.

5) Inflammation:
Inflammation is the body's response to injury or infection, characterized by redness, heat, swelling, and pain. The research discusses how chronic inflammation in conditions like otitis media may be exacerbated by factors such as gastro-esophageal reflux, contributing to prolonged middle ear problems in children.

6) Measurement:
Measurement refers to the process of quantifying characteristics or phenomena. In the context of the study, measuring pepsin levels in middle ear effusions serves as a critical method for assessing the influence of gastro-esophageal reflux on otitis media with effusion, providing concrete data for analysis.

7) Vomiting:
Vomiting is the expulsion of stomach contents through the mouth, often due to diseased or irritated conditions in the digestive tract. In the referred study, it is noted as one of the gastro-esophageal symptoms in children, indicating a potential connection between reflux issues and ear infections.

8) Egypt:
Egypt is a country in northeastern Africa where the study took place. The demographic specificity of the study is significant as it highlights the prevalence of chronic otitis media in a developing country setting, which may differ from findings in developed nations.

9) Pain:
Pain is an unpleasant sensory and emotional experience often linked to tissue damage or dysfunction. In this study, pain is mentioned as a symptom associated with chronic middle ear effusion, emphasizing the discomfort experienced by children suffering from this condition.

10) Developing:
Developing is a term that describes countries or regions with less economic and social infrastructure. The study emphasizes that chronic secretory otitis media is especially prevalent in developing countries, impacting children's health significantly and drawing attention to resource allocation for their healthcare.

11) Swallowing:
Swallowing is the process of moving food from the mouth to the stomach. In the context of the study, difficulty swallowing emerges as one of the gastro-esophageal symptoms reported by patients, suggesting that reflux may affect both ear and digestive health in affected children.

12) Language:
Language involves communication, often denoting verbal skills essential for development. In this study, impaired speech and language emerge as consequences of diminished hearing due to otitis media, highlighting the broader implications of the disease on children's growth and educational progress.

13) Allergy:
Allergy refers to an immune response to a substance (allergen) that the body mistakenly identifies as harmful. The study acknowledges that allergy is a potential contributor to chronic otitis media; however, patients with a history of allergic disease were excluded from the analysis.

14) Nausea:
Nausea is the sensation of an urge to vomit. In the study, nausea is listed among gastro-esophageal symptoms, indicating that children with chronic otitis media with effusion also experience gastrointestinal issues that may influence their overall health and require consideration in management strategies.

15) Line:
Line refers to a treatment or intervention strategy. In the study, conservative lines of treatment for otitis media that had failed were noted, suggesting that understanding different management options is crucial for addressing chronic cases effectively and improving the long-term outcomes for children.

16) Malnutrition:
Malnutrition occurs when the body does not obtain adequate nutrients due to diet deficiencies. The study references malnutrition as a potential complication of chronic gastro-esophageal reflux disease (GERD), indicating how untreated conditions can lead to severe health complications, especially in developing children.

17) Controversy:
Controversy refers to disagreement or debate over a topic. The text notes that there remains considerable controversy regarding the pathogenesis of otitis media with effusion, emphasizing the need for ongoing research to clarify factors contributing to this prevalent childhood condition.

18) Observation:
Observation is the act of monitoring or examining a phenomenon. The study details specific observations concerning the symptoms and conditions of children with otitis media and gastro-esophageal reflux, which may inform future treatments and highlight a link between these health issues.

19) Discussion:
Discussion involves the analysis and interpretation of research findings. In the context of this study, the discussion section reflects on the implications of the findings, exploring the relationship between gastro-esophageal reflux and otitis media, informing future research directions and clinical practices.

20) Antibiotic (Antibacterial):
An antibiotic is a medication used to treat bacterial infections. The study mentions antibiotics as part of postoperative care after myringotomy, indicating that managing secondary infections is crucial for recovery in children suffering from chronic otitis media with effusion.

21) Suffering:
Suffering refers to the experience of physical or psychological pain. The study addresses the suffering of children experiencing chronic ear conditions like otitis media, underlining the social and health burdens these persistent issues pose for affected families and healthcare systems.

22) Crocodile:
Crocodile refers to a surgical instrument used to place ventilation tubes in the ear during procedures such as myringotomy. Its mention in the study signifies the technical aspects of the surgical interventions performed on children with chronic otitis media to alleviate their symptoms.

23) Deafness:
Deafness refers to a partial or total inability to hear. Chronic otitis media with effusion is noted as a primary cause of childhood deafness in the study, underscoring the critical need for early intervention and effective treatment strategies to prevent long-term auditory impairments.

24) Incision:
Incision refers to a surgical cut made to access tissues or organs. The study highlights the myringotomy procedure where an incision is made in the tympanic membrane to treat otitis media, showcasing the surgical approaches taken to manage the disease effectively.

25) Surface:
Surface often pertains to the outer layer of tissues or organs. In the context of the study, the gastric contents' effect on the esophageal mucosal surface is discussed, illustrating how reflux may impact various bodily systems, including the upper respiratory tract.

26) Nature:
Nature refers to the intrinsic qualities or characteristics of a substance or condition. In the study, the nature of middle ear effusion, which can vary in clarity and infection signs, is crucial for determining the appropriate diagnosis and treatment methods for children with otitis media.

27) Sign:
Sign in a medical context can refer to objective evidence observed during an examination, indicating a condition's presence. The study details otoscopic signs, such as the appearance of the tympanic membrane, which are essential for diagnosing chronic otitis media in children.

28) Post:
Post typically refers to after a procedure or event. The study mentions 'postoperatively' concerning the treatment protocol followed after myringotomy, emphasizing the importance of following up on patients to ensure successful recovery from chronic otitis media.

29) Life:
Life refers to the existence of living organisms and their experiences. In the study, the implications of chronic otitis media on children's quality of life are significant, considering how such conditions can interfere with development, communication, and overall well-being.

Other Science Concepts:

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Discover the significance of concepts within the article: ‘Role of reflux in the etiology of otitis media with effusion in children’. Further sources in the context of Science might help you critically compare this page with similair documents:

Abdominal pain, Gastro Esophageal Reflux Disease, Statistically significant correlation, Eustachian tube dysfunction, Otitis media with effusion, Pepsin concentration, Pediatric otolaryngology, Otoscopic findings.

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