This 2020 systematic review and meta analysis published in The Laryngoscope peer-reviewed journal, aimed to determine whether there is an association between a diagnosis of gastroesophageal reflux disease and a diagnosis of recurrent croup. The term “recurrent croup” is typically defined as patients having greater than 2 or 3 episodes of croup. Risk factors and causes of recurrent croup are not well established, but GERD has been theorized to play a role by damaging the mucosal barrier of the trachea, thus increasing susceptibility to infection.
To answer this question, five separate databases were searched, 346 initial records, and ultimately 15 studies met the inclusion criteria (2 retrospective cohort, 13 cross-sectional). Thirteen out of those fifteen studies did support an association between recurrent croup and GERD. However, most of the studies did not include a control group thereby limiting the evidence.
A secondary question of this review was to determine if anti-reflux medications are associated with improvement to current croup in pediatrics patients (vs. pediatric patients with recurrent croup who are not treated for GERD). Based on the conclusion of these studies, there is evidence of reflux medication resulting in a reduced incidence of croup symptoms. Overall, the conclusions made by this review require future better-designed trials in order to accurately determine the association between GERD and recurrent croup. This article is clinically significant nonetheless, because it lays the foundation and provides promising findings for pediatric patients with recurrent croup.
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