Esophageal and gastric motor abnormalities in gastroesophageal reflux during infancy

Hillemeier, A. Craig; Grill, Bruce B.; McCallum, Richard W.; Gryboski, Joyce D.

doi:10.1016/0016-5085(83)90140-3

Cited by 121 publications

(45 citation statements)

References 14 publications

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“…Ultrasound and scintigraphic studies showed delayed gastric emptying in infants with GERD compared with control subjects [11,12], whereas a more recent study showed that premature babies with demonstrated GERD by pHmetry did not have delayed gastric emptying as measured with the octanoic acid breath test [13].…”

Section: Gastric Emptying Of the Whole Stomach And Gastroesophageal Rmentioning

confidence: 97%

Gastroesophageal reflux and gastric emptying, revisited

Emerenziani

Sifrim

2005

Curr Gastroenterol Rep

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Total gastric emptying is delayed in 10% to 33% of adult patients with gastroesophageal reflux disease (GERD), but a strong correlation between duration of gastric emptying and severity of acid reflux or esophagitis has never been proved. Previous studies reported that patients with GERD might have exaggerated postprandial fundus relaxation with retention of food and triggering of transient lower esophageal sphincter relaxations (TLESRs). There is a positive correlation between postprandial fundus relaxation and number of TLESRs and also between proximal gastric emptying and esophageal acid exposure. However, new studies suggest that a high number of TLESRs and reflux events may occur even with accelerated gastric emptying, and prolonged gastric retention might be associated with less rather than more esophageal acid exposure. Using simultaneous gastric emptying and esophageal pH impedance we found that the rate of gastric emptying might determine the acidity and proximal extent of reflux: The slower the emptying, the higher the pH and proximal extent of the refluxate.

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Section: Gastric Emptying Of the Whole Stomach And Gastroesophageal Rmentioning

confidence: 97%

Gastroesophageal reflux and gastric emptying, revisited

Emerenziani

Sifrim

2005

Curr Gastroenterol Rep

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“…These defects were also more prevalent with increasing severity of disease [12,14,19,20,26]. In contrast, Sondheimer [17] reported few motility defects in infants with GERD but found that these infants swallowed less frequently, particularly during sleep.…”

Section: Esophageal Volume Clearancementioning

confidence: 94%

“…Measurements in children with GERD indicate that average LES pressures range from 4 to 25 mm Hg, with most studies recording LES pressures of greater than 10 mm Hg [7][8][9][10][11][12][13][14][15][16][17][18][19][20]. Interestingly, studies that have compared GERD children with "normal" children (ie, those who presented with symptoms but were found to be free of GERD after further investigation) found LES pressure to be 6 to 15 mm Hg lower in children with GERD [7,19].…”

Section: Lower Esophageal Sphinctermentioning

confidence: 97%

“…In addition to changes in esophageal pressure wave propagation, severe GERD with reflux esophagitis is associated with a 30% to 50% decrease in pressure wave amplitude, indicating that the contractile strength of the esophagus is also impaired [12,14,15,19,20,26]. However, lower pressure wave amplitude does not necessarily lead to impaired clearance, as low peak amplitude pressure waves have been shown to be as effective as high peak amplitudes in facilitating bolus transit of liquids, provided that a threshold amplitude of greater than 20 mm Hg above intrabolus pressure is reached [38].…”

Section: Esophageal Volume Clearancementioning

confidence: 97%

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Pathophysiological mechanisms of Gastroesophageal reflux disease in children

Davidson

Omari

2001

Curr Gastroenterol Rep

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Gastroesophageal reflux (GER) is an extremely common pediatric problem, but only in the past few years have we developed a better understanding of its pathophysiology. This is related to the wider use of investigative tools such as flexible endoscopy, 24-hour pH monitoring, and more recently, micromanometric methods and noninvasive breath tests, which have been particularly useful in infants. This paper reviews our current understanding of the esophageal and gastric mechanisms contributing to the pathophysiology of GER. In this context, we also highlight areas where new therapeutic approaches may be beneficial.

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“…Neben einer konservativen Therapie mit Protonenpumpeninhibitoren (PPI) -abgeleitet von der Standardtherapie der Refluxösophagi-tis -gibt es insbesondere bei extraösopha-gealen Manifestationen einer pathologischen Refluxaktivität gute Argumente für eine chirurgische Vorgehensweise [4,5].…”

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Extraösophageale Refluxerkrankungen bei Kindern

Ahrens

2012

HNO

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Gastroesophageal reflux diseases represent a diagnostic challenge, not least since no single diagnostic procedure has been able to establish a causal link between pathological reflux and chronic upper and lower airway diseases. By combining a variety of procedures which point to a link (multi-channel pH measurement, impedance measurement of the esophagus, video panendoscopy, bronchoalveolar lavage, and quantification of lipid-laden alveolar macrophages) and careful differential and exclusion diagnoses, reflux-related diseases can be diagnosed with sufficient precision. In addition to initially successful PPI therapy, surgical intervention (hemifundoplication) is the method of choice in children.

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Esophageal and gastric motor abnormalities in gastroesophageal reflux during infancy

Cited by 121 publications

References 14 publications

Gastroesophageal reflux and gastric emptying, revisited

Gastroesophageal reflux and gastric emptying, revisited

Pathophysiological mechanisms of Gastroesophageal reflux disease in children

Extraösophageale Refluxerkrankungen bei Kindern

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