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Published in: Pediatric Surgery International 10/2017

01-10-2017 | Original Article

Characteristics of gastroesophageal reflux in pediatric patients with neurological impairment

Authors: Hisayoshi Kawahara, Yuko Tazuke, Hideki Soh, Noriaki Usui, Hiroomi Okuyama

Published in: Pediatric Surgery International | Issue 10/2017

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Abstract

Purpose

To clarify the characteristics of gastroesophageal reflux (GER) in pediatric patients with neurological impairment (NI).

Methods

Twenty-six patients with NI, 1–17-year-old, fed via a nasogastric tube were categorized based on the absence (group I) or presence (group II) of abnormal GER, defined with multichannel intraluminal impedance-pH monitoring as %time with an esophageal pH <4.0 being ≥5.0% or number of liquid/mixed bolus reflux events(RE) >70 in 24 h.

Results

%Time and number of distal and proximal bolus REs were not significantly different between acid and nonacid REs. %Time of acid bolus RE and that of acid and total number of distal and proximal bolus REs were significantly higher in group II than in group I. Mean acid clearance time was significantly longer in group II. Median bolus clearance time was similar between the groups. No bolus RE parameters were significantly different between acid and nonacid REs in group I. Acid bolus RE was significantly higher than nonacid RE in terms of %time and number of proximal bolus RE in group II.

Conclusion

Acid REs significantly increased in pediatric patients with NI with abnormal GER. The number of acid and nonacid REs was comparable in patients without abnormal GER.
Literature
1.
go back to reference Ravelli AM, Milla PJ (1998) Vomiting and gastroesophageal motor activity in children with disorders of the central nervous system. J Pediatr Gastroenterol Nutr 26:56–63CrossRefPubMed Ravelli AM, Milla PJ (1998) Vomiting and gastroesophageal motor activity in children with disorders of the central nervous system. J Pediatr Gastroenterol Nutr 26:56–63CrossRefPubMed
2.
3.
go back to reference Del Buono R, Wenzl TG, Rawat D et al (2006) Acid and nonacid gastro-oesophageal reflux in neurologically impaired children: investigation with the multiple intraluminal impedance procedure. J Pediatr Gastroenterol Nutr 43:331–335CrossRefPubMed Del Buono R, Wenzl TG, Rawat D et al (2006) Acid and nonacid gastro-oesophageal reflux in neurologically impaired children: investigation with the multiple intraluminal impedance procedure. J Pediatr Gastroenterol Nutr 43:331–335CrossRefPubMed
4.
go back to reference Fukahori S, Asagiri K, Ishii S et al (2013) Pre and post-operative evaluation of gastroesophageal reflux and esophageal motility in neurologically impaired children using combined pH-multichannel intraluminal impedance measurements. Pediatr Surg Int 29:545–551CrossRefPubMedPubMedCentral Fukahori S, Asagiri K, Ishii S et al (2013) Pre and post-operative evaluation of gastroesophageal reflux and esophageal motility in neurologically impaired children using combined pH-multichannel intraluminal impedance measurements. Pediatr Surg Int 29:545–551CrossRefPubMedPubMedCentral
5.
go back to reference Kawahara H, Tazuke Y, Soh H et al (2014) Does laparoscopy-aided gastrostomy placement improve or worsen gastroesophageal reflux in patients with neurological impairment? J Pediatr Surg 49:1742–1745CrossRefPubMed Kawahara H, Tazuke Y, Soh H et al (2014) Does laparoscopy-aided gastrostomy placement improve or worsen gastroesophageal reflux in patients with neurological impairment? J Pediatr Surg 49:1742–1745CrossRefPubMed
6.
go back to reference Pilic D, Fröhlich T, Nöh F et al (2011) Detection of gastroesophageal reflux in children using combined multichannel intraluminal impedance and pH measurement: data from the German Pediatric Impedance Group. J Pediatr 158:650–654CrossRefPubMed Pilic D, Fröhlich T, Nöh F et al (2011) Detection of gastroesophageal reflux in children using combined multichannel intraluminal impedance and pH measurement: data from the German Pediatric Impedance Group. J Pediatr 158:650–654CrossRefPubMed
7.
go back to reference Lightdale JR, Gremse DA, Section on Gastroenterology, Hepatology, and Nutrition (2013) Gastroesophageal reflux: management guidance for the pediatrician. Pediatrics 131:e1684–e1695CrossRefPubMed Lightdale JR, Gremse DA, Section on Gastroenterology, Hepatology, and Nutrition (2013) Gastroesophageal reflux: management guidance for the pediatrician. Pediatrics 131:e1684–e1695CrossRefPubMed
8.
go back to reference Safe M, Cho J, Krishnan U (2016) Combined multichannel intraluminal impedance and pH measurement in detecting gastroesophageal reflux disease in children. J Pediatr Gastroenterol Nutr 63:e98–e106CrossRefPubMed Safe M, Cho J, Krishnan U (2016) Combined multichannel intraluminal impedance and pH measurement in detecting gastroesophageal reflux disease in children. J Pediatr Gastroenterol Nutr 63:e98–e106CrossRefPubMed
9.
go back to reference Vicente Y, da Rocha C, Hernandez-Peredo G et al (2002) Esophageal acid clearance: more volume-dependent than motility-dependent in healthy piglets. J Pediatr Gastroenterol Nutr 35:173–179CrossRefPubMed Vicente Y, da Rocha C, Hernandez-Peredo G et al (2002) Esophageal acid clearance: more volume-dependent than motility-dependent in healthy piglets. J Pediatr Gastroenterol Nutr 35:173–179CrossRefPubMed
11.
go back to reference Kawahara H, Dent J, Davidson G (1997) Mechanisms responsible for gastroesophageal reflux in children. Gastroenterology 113:399–408CrossRefPubMed Kawahara H, Dent J, Davidson G (1997) Mechanisms responsible for gastroesophageal reflux in children. Gastroenterology 113:399–408CrossRefPubMed
12.
go back to reference Herculano JR Jr, Troncon LE, Aprile LR et al (2004) Diminished retention of food in the proximal stomach correlates with increased acidic reflux in patients with gastroesophageal reflux disease and dyspeptic symptoms. Dig Dis Sci 49:750–756CrossRefPubMed Herculano JR Jr, Troncon LE, Aprile LR et al (2004) Diminished retention of food in the proximal stomach correlates with increased acidic reflux in patients with gastroesophageal reflux disease and dyspeptic symptoms. Dig Dis Sci 49:750–756CrossRefPubMed
13.
go back to reference Emerenziani S, Sifrim D (2005) Gastroesophageal reflux and gastric emptying, revisited. Curr Gastroenterol Rep 7:190–195CrossRefPubMed Emerenziani S, Sifrim D (2005) Gastroesophageal reflux and gastric emptying, revisited. Curr Gastroenterol Rep 7:190–195CrossRefPubMed
Metadata
Title
Characteristics of gastroesophageal reflux in pediatric patients with neurological impairment
Authors
Hisayoshi Kawahara
Yuko Tazuke
Hideki Soh
Noriaki Usui
Hiroomi Okuyama
Publication date
01-10-2017
Publisher
Springer Berlin Heidelberg
Published in
Pediatric Surgery International / Issue 10/2017
Print ISSN: 0179-0358
Electronic ISSN: 1437-9813
DOI
https://doi.org/10.1007/s00383-017-4139-7

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