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Gastroesophageal Reflux

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Abstract

Gastroesophageal reflux (GER) is the retrograde passage of gastric contents into the esophagus. GER is so common in infancy and childhood that it is difficult to distinguish “normal” spitting or regurgitation from gastroesophageal reflux disease (GERD). In most infantile cases, GERD has a benign clinical course with a spontaneous tendency to improve over time. However, occasionally it can evolve into a severe (or even lethal) condition requiring aggressive treatment. In these cases, important therapeutic decisions are needed because surgery is often required.

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References

  1. Liebermann-Meffert D, Allgower M, Schmid P, Blum AL (1979) Muscular equivalent of the lower esophageal sphincter. Gastroenterology 76:31–38

    PubMed  CAS  Google Scholar 

  2. Vicente Y, Da Rocha C, Yu J, et al (2001) Architecture and function of the gastroesophageal barrier in the piglet. Dig Dis Sci 46:1899–1908

    Google Scholar 

  3. Mittal RK, Sivri B, Schirmer BD, Heine KJ (1993) Effect of crural myotomy on the incidence and mechanism of gastroesophageal reflux in cats. Gastroenterology 105:740–747

    Article  PubMed  CAS  Google Scholar 

  4. von Schonfeld J, Hector M, Evans DF, Wingate DL (1997) Oesophageal acid and salivary secretion: is chewing gum a treatment option for gastro-oesophageal reflux? Digestion 58:111–114

    Article  Google Scholar 

  5. Long JD, Orlando RC (1999) Esophageal submucosal glands: structure and function. Am J Gastroenterol 94:2818–2824

    Article  PubMed  CAS  Google Scholar 

  6. Hopwood D (1995) Oesophageal defence mechanisms. Digestion 56:5–8

    Article  PubMed  CAS  Google Scholar 

  7. Marcinkiewicz M, Grabowska SZ, Czyzewska E (1998) Role of epidermal growth factor (EGF) in oesophageal mucosal integrity. Curr Med Res Opin 14:145–153

    Article  PubMed  CAS  Google Scholar 

  8. Chitkara DK, Fortunato C, Nurko S (2004) Prolonged monitoring of esophageal motor function in healthy children. J Pediatr Gastroenterol Nutr 38:192–197

    Article  PubMed  Google Scholar 

  9. Vicente Y, da Rocha C, Perez-Mies B, Madero R, Tovar JA (2004) Effect of reflux and esophagitis on esophageal volume and acid clearance in piglets. J Pediatr Gastroenterol Nutr 38:328–337

    Article  PubMed  Google Scholar 

  10. Wang W, Tovar JA, Eizaguirre I, Aldazabal P (1993) Airway obstruction and gastroesophageal reflux: an experimental study on the pathogenesis of this association. J Pediatr Surg 28:995–998

    Article  PubMed  CAS  Google Scholar 

  11. Kawahara H, Dent J, Davidson G (1997) Mechanisms responsible for gastroesophageal reflux in children. Gastroenterology 113:399–408

    Article  PubMed  CAS  Google Scholar 

  12. Goyal RK, Padmanabhan R, Sang Q (2001) Neural circuits in swallowing and abdominal vagal afferent-mediated lower esophageal sphincter relaxation. Am J Med 111 (Suppl 8A):95S–105S

    Article  PubMed  Google Scholar 

  13. Gustafsson PM, Tibbling L (1994) Gastro-oesophageal reflux and oesophageal dysfunction in children and adolescents with brain damage. Acta Paediatr 83:1081–1085

    Article  PubMed  CAS  Google Scholar 

  14. Davies MRQ (1996) Anatomy of the extrinsic nerve supply of the oesophagus in oesophageal atresia of the common type. Pediatr Surg Int 11:230–233

    Article  PubMed  CAS  Google Scholar 

  15. Pederiva F, Burgos E, Francica I, Zuccarello B, Martinez L, Tovar JA (2008) Intrinsic esophageal innervation in esophageal atresia without fistula. Pediatr Surg Int 24:95–100

    Article  PubMed  Google Scholar 

  16. Zuccarello B, Spada A, Turiaco N (2009) Intramural ganglion structures in esophageal atresia: a morphologic and immunohistochemical study. Int J Pediatr 2009:695–837

    Google Scholar 

  17. Midrio P, Alaggio R, Strojna A et al (2010) Reduction of interstitial cells of Cajal in esophageal atresia. J Pediat Gastroenterol Nutr 51:610–617

    Google Scholar 

  18. Tovar JA, Diez Pardo JA, Murcia J, Prieto G, Molina M, Polanco I (1995) Ambulatory 24-hour manometric and pH metric evidence of permanent impairment of clearance capacity in patients with esophageal atresia. J Pediatr Surg 30:1224–1231

    Article  PubMed  CAS  Google Scholar 

  19. Montedonico S, Diez-Pardo JA, Possogel AK, Tovar JA (1999) Effects of esophageal shortening on the gastroesophageal barrier: an experimental study on the causes of reflux in esophageal atresia. J Pediatr Surg 34:300–303

    Article  PubMed  CAS  Google Scholar 

  20. Qi B, Soto C, Diez-Pardo JA, Tovar JA (1997) An experimental study on the pathogenesis of gastroesophageal reflux after repair of diaphragmatic hernia. J Pediatr Surg 32:1310–1313

    Article  PubMed  CAS  Google Scholar 

  21. Stolar CJ, Levy JP, Dillon PW, Reyes C, Belamarich P, Berdon WE (1990) Anatomic and functional abnormalities of the esophagus in infants surviving congenital diaphragmatic hernia. Am J Surg 159:204–207

    Article  PubMed  CAS  Google Scholar 

  22. Martinez L, Pederiva F, Martinez-Calonge W, Aras-Lopez R, Tovar JA (2009) The myenteric plexus of the esophagus is abnormal in an experimental congenital diaphragmatic hernia model. Eur J Pediatr Surg 19:163–167

    Article  PubMed  CAS  Google Scholar 

  23. Pederiva F, Rodriguez JI, Ruiz-Bravo E, Martinez L, Tovar JA (2009) Abnormal intrinsic esophageal innervation in congenital diaphragmatic hernia: a likely cause of motor dysfunction. J Pediatr Surg 44:496–499

    Article  PubMed  Google Scholar 

  24. Qi B, Diez-Pardo JA, Soto C, Tovar JA (1996) Transdiaphragmatic pressure gradients and the lower esophageal sphincter after tight abdominal wall plication in the rat. J Pediatr Surg 31:1666–1669

    Article  PubMed  CAS  Google Scholar 

  25. Koivusalo A, Rintala R, Lindahl H (1999) Gastroesophageal reflux in children with a congenital abdominal wall defect. J Pediatr Surg 34:1127–1129

    Article  PubMed  CAS  Google Scholar 

  26. Jolley SG, Lorenz ML, Hendrickson M, Kurlinski JP (1999) Esophageal pH monitoring abnormalities and gastroesophageal reflux disease in infants with intestinal malrotation. Arch Surg 134:747–752

    Article  PubMed  CAS  Google Scholar 

  27. Boix-Ochoa J, Canals J (1976) Maturation of the lower esophagus. Journal of Pediatric Surgery 11:749–756

    Article  PubMed  CAS  Google Scholar 

  28. Hollwarth M, Uray E (1985) Physiology and pathophysiology of the esophagus in childhood. Prog Pediatr Surg 18:1–13

    Article  PubMed  CAS  Google Scholar 

  29. Omari T (2005) Gastro-oesophageal reflux disease in infants and children: new insights, developments and old chestnuts. J Pediatr Gastroenterol Nutr 41 (Suppl 1):S21–S23

    Article  PubMed  Google Scholar 

  30. Omari TI, Miki K, Fraser R et al (1995) Esophageal body and lower esophageal sphincter function in healthy premature infants. Gastroenterology 109:1757–1764

    Google Scholar 

  31. Omari TI, Miki K, Davidson G et al (1997) Characterisation of relaxation of the lower oesophageal sphincter in healthy premature infants. Gut 40:370–375

    Google Scholar 

  32. Carre IJ (1985) Management of gastro-oesophageal reflux. Arch Dis Child 60:71–75

    Article  PubMed  CAS  Google Scholar 

  33. Tovar JA, Luis AL, Encinas JL et al (2007) Pediatric surgeons and gastroesophageal reflux. J Pediatr Surg 42:277–283

    Google Scholar 

  34. Gorrotxategi P, Reguilon MJ, Arana J et al (1995) Gastroesophageal reflux in association with the Sandifer syndrome. Eur J Pediatr Surg 5:203–205

    Google Scholar 

  35. Bobin S, Attal P (1999) Laryngotracheal manifestations of gastroesophageal reflux in children. Pediatr Pulmonol (Suppl) 18:73–75

    Article  CAS  Google Scholar 

  36. Eizaguirre I, Tovar JA (1992) Predicting Preoperatively the outcome of respiratory symptoms of gastroesophageal reflux. J Pediatr Surg 27:848–851

    Article  PubMed  CAS  Google Scholar 

  37. Gold BD (2005) Asthma and gastroesophageal reflux disease in children: exploring the relationship. J Pediatr 146:S13–S20

    Article  PubMed  Google Scholar 

  38. Al-Khawari HA, Sinan TS, Seymour H (2002) Diagnosis of gastro-oesophageal reflux in children. Comparison between oesophageal pH and barium examinations. Pediatr Radiol 32:765–770

    Article  PubMed  Google Scholar 

  39. Orenstein SR, Klein HA, Rosenthal MS (1993) Scintigraphy versus pH probe for quantification of pediatric gastroesophageal reflux: a study using concurrent multiplexed data and acid feedings. J Nucl Med 34:1228–1234

    PubMed  CAS  Google Scholar 

  40. Westra SJ, Wolf BH, Staalman CR (1990) Ultrasound diagnosis of gastroesophageal reflux and hiatal hernia in infants and young children. J Clin Ultrasound 18:477–485

    Article  PubMed  CAS  Google Scholar 

  41. Vandenplas Y, Helven R, Goyvaerts H, Sacre L (1990) Reproducibility of continuous 24 hour oesophageal pH monitoring in infants and children. Gut 31:374–377

    Article  PubMed  CAS  Google Scholar 

  42. Tovar JA, Wang W, Eizaguirre I (1993) Simultaneous gastroesophageal pH monitoring and the diagnosis of alkaline reflux. J Pediatr Surg 28:1386–1392

    Article  PubMed  CAS  Google Scholar 

  43. Lopez-Alonso M, Moya MJ, Cabo JA, et al (2006) Twenty-four-hour esophageal impedance-pH monitoring in healthy preterm neonates: rate and characteristics of acid, weakly acidic, and weakly alkaline gastroesophageal reflux. Pediatrics 118:e299–e308

    Google Scholar 

  44. Vandenplas Y, Salvatore S, Devreker T, Hauser B (2007) Gastro-oesophageal reflux disease: oesophageal impedance versus pH monitoring. Acta Paediatr 96:956–962

    Article  PubMed  Google Scholar 

  45. Vandenplas Y, Ashkenazi A, Belli D et al. (1993) A proposition for the diagnosis and treatment of gastrooesophageal reflux disease in children: a report from a working group on gastro-oesophageal reflux disease. Working Group of the European Society of Paediatric Gastro-enterology and Nutrition (ESPGAN). Eur J Pediatr 152:704–711

    Google Scholar 

  46. Rosen R, Fritz J, Nurko A, Simon D, Nurko S (2008) Lipid-laden macrophage index is not an indicator of gastroesophageal reflux-related respiratory disease in children. Pediatrics 121:e879–e884

    Article  PubMed  Google Scholar 

  47. Dalby-Payne JR, Morris AM, Craig JC (2003) Metaanalysis of randomized controlled trials on the benefits and risks of using cisapride for the treatment of gastroesophageal reflux in children. J Gastroenterol Hepatol 18:196–202

    Article  PubMed  CAS  Google Scholar 

  48. Gibbons TE, Gold BD (2003) The use of proton pump inhibitors in children: a comprehensive review. Paediatr Drugs 5:25–40

    PubMed  Google Scholar 

  49. Kearns GL, Winter HS (2003) Proton pump inhibitors in pediatrics: relevant pharmacokinetics and pharmacodynamics. J Pediatr Gastroenterol Nutr 37 (Suppl 1):S52–S59

    Article  PubMed  CAS  Google Scholar 

  50. Marchetti F, Gerarduzzi T, Ventura A (2003) Proton pump inhibitors in children: a review. Dig Liver Dis 35:738–746

    Article  PubMed  CAS  Google Scholar 

  51. Rudolph CD, Mazur LJ, Liptak GS et al (2001) Guidelines for evaluation and treatment of gastroesophageal reflux in infants and children: recommendations of the North American Society for Pediatric Gastroenterology and Nutrition. J Pediatr Gastroenterol Nutr 32 (Suppl 2):S1–S31

    Google Scholar 

  52. Vandenplas Y, Rudolph CD, Di Lorenzo C et al (2009) Pediatric gastroesophageal reflux clinical practice guidelines: joint recommendations of the North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition (NASPGHAN) and the European Society for Pediatric Gastroenterology, Hepatology, and Nutrition (ESPGHAN). J Pediat Gastroenterol Nutr 49:498–547

    Google Scholar 

  53. Jolley SG, Herbst JJ, Johnson DG, Matlak ME, Book LS (1980) Surgery in children with gastroesophageal reflux and respiratory symptoms. J Pediatr 96:194–198

    Article  PubMed  CAS  Google Scholar 

  54. Valusek PA, St Peter SD, Tsao K, Spilde TL, Ostlie DJ, Holcomb GW, 3rd (2007) The use of fundoplication for prevention of apparent life-threatening events. J Pediatr Surg 42:1022–1024 (discussion 1025)

    Article  PubMed  Google Scholar 

  55. Roy-Choudhury S, Ashcraft KW (1998) Thal fundoplication for pediatric gastroesophageal reflux disease. Semin Pediatr Surg 7:115–120

    PubMed  CAS  Google Scholar 

  56. Boix-Ochoa J (1986) The physiologic approach to the management of gastric esophageal reflux. J Pediatr Surg 21:1032–1039

    Article  PubMed  CAS  Google Scholar 

  57. Montupet P (2002) Laparoscopic Toupet’s fundoplication in children. Semin Laparosc Surg 9:163–167

    Article  PubMed  Google Scholar 

  58. Siddiqui MR, Abdulaal Y, Nisar A, Ali H, Hasan F (2011) A meta-analysis of outcomes after open and laparoscopic Nissen’s fundoplication for gastro-oesophageal reflux disease in children. Pediatr Surg Int 27:359–366

    Article  PubMed  Google Scholar 

  59. Bustorff-Silva J, Fonkalsrud EW, Perez CA, Quintero R, Martin L, Villasenor E, Atkinson JB (1999) Gastric emptying procedures decrease the risk of postoperative recurrent reflux in children with delayed gastric emptying. J Pediatr Surg 34:79–82

    Article  PubMed  CAS  Google Scholar 

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Correspondence to Juan A. Tovar .

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Tovar, J.A. (2013). Gastroesophageal Reflux. In: Lima, M. (eds) Pediatric Thoracic Surgery. Springer, Milano. https://doi.org/10.1007/978-88-470-5202-4_13

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  • DOI: https://doi.org/10.1007/978-88-470-5202-4_13

  • Publisher Name: Springer, Milano

  • Print ISBN: 978-88-470-5201-7

  • Online ISBN: 978-88-470-5202-4

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