Small Volumes of Feed Can Trigger Transient Lower Esophageal Sphincter Relaxation and Gastroesophageal Reflux in the Right Lateral Position in Infants

Michiel van Wijk, Marc Benninga, Geoffrey Davidson, Ross Haslam, Taher Omari

    Research output: Contribution to journalArticle

    29 Citations (Scopus)

    Abstract

    Objective: To investigate the threshold amount of constantly infused feed needed to trigger lower esophageal sphincter relaxation (TLESR) in the right lateral position (RLP) and left lateral position (LLP). Study design: Eight healthy infants (3 male; gestational age: 32.9 ± 2.4 weeks; corrected age: 36.1 ± 1.3 weeks) were studied using an esophageal impedance-manometry catheter incorporating an intragastric infusion port. After tube placement, infants were randomly positioned in RLP or LLP. They were then tube-fed their normal feed (62.5 [40 to 75] mL) at an infusion rate of 160 mL/h. Recordings were made during the feed and 15 minutes thereafter. The study was repeated with the infant in the opposite position. Results: More TLESRs were triggered in the RLP compared with LLP (4.0 [3.0 to 6.0] vs 2.5 [1.0 to 3.0], P = .027). First TLESR occurred at a significantly lower infused volume in RLP compared with LLP (10.6 ± 9.4 vs 21.0 ± 4.9 mL, P = .006). The percentage of feed infused at time of first TLESR was significantly lower in RLP compared with LLP (17.6% ± 15.5% vs 35.4% ± 8.02%, P = .005). Conclusions: In the RLP, TLESRs and gastroesophageal reflux are triggered at volumes unlikely to induce gastric distension.

    Original languageEnglish
    Pages (from-to)744-748.e1
    Number of pages6
    JournalJournal of Pediatrics
    Volume156
    Issue number5
    DOIs
    Publication statusPublished - May 2010

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