REFLUX SYMPTOMS IN 100 NORMAL INFANTS - DIAGNOSTIC VALIDITY OF THE INFANT GASTROESOPHAGEAL REFLUX QUESTIONNAIRE

To identify the prevalence of reflux symptoms in normal infants, to ch aracterize the diagnostic validity of a previously described 138-item infant Gastroesophageal Reflux Questionnaire (I-GERQ) for separating n ormal infants from those with gastroesophageal reflux disease (GERD), and to identify potentially provocative caretaking practices, we admin istered the questionnaire to 100 infants attending a well-baby clinic (normals) and to 35 infants referred to the Gastroenterology Division for evaluation for GERD and testing positive on esophageal pH probe or biopsy (GERD infants), Differences were analyzed by Chi-square, and o dds ratios were defined. The diagnostic validity of a 25-point I-GERQ GERD score based on 11 items on the questionnaire was evaluated by cal culating its sensitivity, specificity, and positive and negative predi ctive values. We found that normal infants had a high prevalence of re flux symptoms, such as daily regurgitation (40%), respiratory symptoms , crying more than an hour a day (17%), arching (10%), or daily hiccup s (36%) but that many symptoms were significantly more prevalent in th e GERD than in the normal infants (Chi-square P < .05), and odds ratio s were above 3 for nearly 20 items. The positive and negative predicti ve values for the 25-point I-GERQ score were 1.00 and .94-.98, respect ively. Environmental smoke exposure did not quite reach significance a s a provocative factor for GERD. Although normal infants have a high p revalence of symptoms suggesting GERD, a simple questionnaire-based sc ore is a valid diagnostic test with high positive and negative predict ive values.