Grant: Master's Award: Canada Graduate Scholarships

Background: With up to 25% of children affected in their first year, reflux is a very important pediatric health concern. It could lead to growth problems, respiratory distress and sleep disturbances amongst other symptoms, thus the need for a prompt diagnosis and targeted therapy. Objective: In children, there currently exists no definitive diagnostic tool for the objective evaluation of laryngopharyngeal reflux (LPR) by flexible laryngoscopy. Definitive age-appropriate questionnaires on gastroesophageal and laryngopharyngeal reflux for population screening are also lacking. The current study proposes to construct and validate a pediatric reflux finding score (RFS) by correlating the LPR diagnostic gold-standard, 24-hour double-probe pH results, with findings of LPR on flexible laryngoscopy. It also proposes to construct and validate screening questionnaires for reflux. Methods: This is a blinded controlled prospective study involving 136 patients aged 0-18 years and is a collaboration between the pediatric gastroenterology and otolaryngology departments at our institution. Initially, a RFS and age-appropriate reflux questionnaires were built. Then starting at a set date, all children with suspected symptoms of reflux have been considered for inclusion in the study to receive a 24-hour double-probe pH study and an upper airway flexible endoscopy. Age-appropriate questionnaires on reflux are also administered. All flexible endoscopies are recorded and scored independently by three blinded otolaryngologists using the proposed pediatric RFS. The pH results, questionnaire results and the RFS are then correlated and validated. Results: Recruitment is ongoing, with 30 patients having completed the study to date. Conclusion: This is a very important study that will help establish essential screening, diagnostic, follow-up and research tools for children suffering from reflux.