Evaluation of gastroesophageal function and mechanisms underlying gastroesophageal reflux in infants and adults born with esophageal atresia

Michiel van Wijk, Fransje Knüppe, Taher Omari, Justin de Jong, Marc Benninga

    Research output: Contribution to journalArticle

    30 Citations (Scopus)

    Abstract

    Purpose: To evaluate the mechanisms underlying gastroesophageal reflux (GER) following esophageal atresia (EA) repair and gastroesophageal function in infants and adults born with EA. Methods: Ten consecutive infants born with EA as well as 10 randomly selected adult EA patients were studied during their first postoperative follow-up visit and a purposely planned visit, respectively. A 13C-octanoate breath test and esophageal pH-impedance-manometry study were performed. Mechanisms underlying GER and esophageal function were evaluated. Results: Transient lower esophageal sphincter relaxation (TLESR) was the most common mechanism underlying GER in infants and adults (66% and 62%, respectively). In 66% of all GER episodes, no clearing mechanism was initiated. On EFT, normal motility patterns were seen in six patients (four infants, two adults). One of these adults had normal motility overall (> 80% of swallows). Most swallows (78.8%) were accompanied by abnormal motility patterns. Despite this observation, impedance showed normal bolus transit in 40.9% of swallows. Gastric emptying was delayed in 57.1% of infants and 22.2% of adults. Conclusions: TLESR is the main mechanism underlying GER events in patients with EA. Most infants and adults have impaired motility, delayed bolus clearance, and delayed gastric emptying. However, normal motility patterns were seen in a minority of patients.

    Original languageEnglish
    Pages (from-to)2496-2505
    Number of pages10
    JournalJournal of Pediatric Surgery
    Volume48
    Issue number12
    DOIs
    Publication statusPublished - Dec 2013

    Keywords

    • Esophageal atresia
    • Esophageal function test
    • Gastric emptying
    • Gastroesophageal reflux
    • Impedance
    • Manometry

    Fingerprint Dive into the research topics of 'Evaluation of gastroesophageal function and mechanisms underlying gastroesophageal reflux in infants and adults born with esophageal atresia'. Together they form a unique fingerprint.

    Cite this