Published online August 1, 2005
PEDIATRICS Vol. 116 No. 2 August 2005, pp. 513 (doi:10.1542/peds.2005-1002)
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Misconceptions Concerning Gastroesophageal Reflux in Children: In Reply

Donald A. Brand, PhD
Robin L. Altman, MD
Department of Pediatrics
New York Medical College
Vahalla, NY 10595

In Reply.—

Figure 1 of our article provides information about the relative yields of different diagnostic tests used in the evaluation of infants after an apparent life-threatening event (ALTE). In discussing the figure, we emphasize that the rank order of tests in the figure does not imply a simple formula for deciding which tests to order (see page 890). To illustrate this point, we later refer to the problem of gastroesophageal reflux, noting that many patients have reflux that does not precipitate an ALTE, and that the presence of reflux in a patient who has had an ALTE does not prove a cause-effect relationship (see page 892). As Drs Bisset and Frush note, this uncertainty surrounding the diagnosis of reflux in ALTE patients may be compounded when an upper gastrointestinal series forms the basis for the diagnosis. We thank them for reminding readers that this is not the best test for detecting gastroesophageal reflux, for explaining in exquisite detail why this is so, and for encouraging physicians to consider other tests for reflux when evaluating an ALTE.

PEDIATRICS (ISSN 1098-4275). ©2005 by the American Academy of Pediatrics




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