Gastric emptying with gastro-oesophageal reflux.

Lorenzo, C Di; Piepsz, Amnon; Ham, Hyoju; Cadranel, S

doi:10.1136/adc.62.5.449

Cited by 127 publications

(61 citation statements)

References 20 publications

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“…Esophageal manometry is critical for identifying transient relaxations of the lower esophageal sphincter as a causative mechanism for GERD [23] and is important in confirming a diagnosis of achalasia or other motor disorders of the esophagus, but is not useful to directly diagnose GERD. Gastroesophageal junction scintigraphy evaluates gastric emptying [24] and may demonstrate aspiration [25], but not morphological changes. Moreover, the technique is poorly standardized, there are no age-specific reference values and observation is limited to the early postprandial period.…”

Section: Diagnostic Approaches To Ger In Childrenmentioning

confidence: 99%

US in the diagnosis of gastroesophageal reflux in children

et al. 2012

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Several techniques have been used to diagnose gastroesophageal reflux (GER) in children, but no single test is sufficiently accurate to completely investigate the problem. Gastroesophageal US has been described as a widely available, noninvasive and sensitive method. It provides morphological and functional information, but its role in the diagnosis of GER in children is still debated. In this paper we review diagnostic approaches to GER in children. We focus on current use of US in the management of children with suspected GER. Reports suggest that US allows exclusion of several non-GER causes of symptoms and that it provides morphological and functional data with high sensitivity and positive predictive value for the diagnosis of GER. Sonographic assessment of findings such as abdominal esophageal length, esophageal diameter, esophageal wall thickness and gastroesophageal angle provide important diagnostic indicators of reflux and related to the degree of GER. There is a need for standardization of the procedure and for defining diagnostic criteria.

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Section: Diagnostic Approaches To Ger In Childrenmentioning

confidence: 99%

US in the diagnosis of gastroesophageal reflux in children

et al. 2012

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“…4,[14][15][16] Other evidence suggests that GERD in infants is primarily a result of LES function rather than delayed gastric emptying. 11,17,18 There are some external factors that contribute to the development of GERD in infants. The supine position places the stomach right at the posterior gastroesophageal junction; when LES relaxation takes place, reflux quickly follows.…”

Section: Contributing Factors In Term and Preterm Infantsmentioning

confidence: 99%

Discerning Differences

Henry

2004

Advances in Neonatal Care

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Gastroesophageal reflux (GER) is a frequently encountered problem in infancy; it commonly resolves spontaneously by 12 months of age. Caregivers are challenged to discriminate between physiologic GER and the much less common and more serious condition of pathologic gastroesophageal reflux disease (GERD). Pathologic GERD may require more extensive clinical evaluation and necessitate treatment. GERD may be primary or secondary; secondary GERD is associated with a number of genetic syndromes, chromosomal abnormalities, birth defects, or a host of neurologic conditions frequently seen in the newborn intensive care unit. This article reviews the unique anatomic, physiologic, developmental, and nutritional vulnerabilities of infants that make them susceptible to GER and GERD. The North American Society of Pediatric Gastroenterology and Nutrition have recently developed a comprehensive evidence-based clinical practice guideline that structures the diagnostic approach and treatment option in infants with suspected and confirmed GERD. These guidelines provide clear definitions of GER and GERD to aid the clinician in distinguishing between the 2 conditions. They emphasize the use of history and physical examination and discuss the indications for the use of other diagnostic procedures, such as upper gastrointestinal studies, nuclear medicine scintiscan, esophagogastroduodenoscopy with biopsy, and esophageal pH probe monitoring. Management of GERD begins with a nonpharmacologic approach; the emphasis is on positioning, a trial of a hypoallergenic formula, and thickening of feedings. When these measures fail to control symptoms, a trial of either histamine(2) antagonists or a proton pump inhibitor may be indicated. Finally, surgical treatment may be needed if all other management measures fail. New sleep recommendations for infants with GERD are now consistent with the American Academy of Pediatrics' standard recommendations. Prone sleep positioning is only considered in unusual cases, where the risk of death and complications from GERD outweighs the potential increased risk of sudden infant death syndrome (SIDS). The nursing care of infants with GER and GERD, as well as relevant issues for parent education and support, are reviewed and are essential elements in managing this common condition.

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“…A range of different techniques (marker dilution, ultrasound, radioscintigraphy, and breath tests) have been used to evaluate gastric emptying of different nutrient/non-nutrient liquid meals (milk formula, apple juice, water). Hillemeier et al [11] first reported delayed gastric emptying in pediatric GERD in 1981, and since that time a number of studies have reported both normal [30,40,[42][43][44][45] and delayed [12,16,[46][47][48][49] gastric emptying in infants and children with GERD. LiVoti et al [49] reported, in a group of infants with GERD (based on confirmation by barium study and pH monitoring), that only 15% of patients had true delayed gastric emptying.…”

Section: Gastric Emptyingmentioning

confidence: 99%

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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Gastric emptying with gastro-oesophageal reflux.

Cited by 127 publications

References 20 publications

US in the diagnosis of gastroesophageal reflux in children

US in the diagnosis of gastroesophageal reflux in children

Discerning Differences

Pathophysiological mechanisms of Gastroesophageal reflux disease in children

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