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September 1977

Gastroesophageal Reflux

Author Affiliations

Department of Pediatrics Division of Pediatric Gastroenterology University of California The Center for the Health Sciences Los Angeles, CA 90024

Am J Dis Child. 1977;131(9):1035. doi:10.1001/archpedi.1977.02120220101020

Sir.—Dr Herbst and co-workers, in the November 1976 issue of the Journal (130:1256, 1976), reported on three children with gastroesophageal reflux (GER), protein-losing enteropathy, and finger clubbing. This valuable documentation again shows the severe consequences of chronic GER in the pediatric-aged patient.

I would like to ask the authors the following questions about their article:

  1. Did the history or physical examination suggest the presence of pulmonary disease? What studies besides chest roentgenograms were done to exclude GER-associated pulmonary disease?

  2. 2. Did you demonstrate sufficient intake of food or was caloric deprivation a contributing cause to the hypoalbuminemia? Did 51Cr studies postoperatively demonstrate a cessation in stool loss in association with a rise in serum albumin level?

  3. 3. Was there a fall-off in height and weight growth prior to surgery and a resumption of normal growth postoperatively?

  4. 4. At what point in the gastrointestinal tract did protein loss occur