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Characteristics of gastroesophageal reflux in pediatric patients with neurological impairment

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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.

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References

  1. Ravelli AM, Milla PJ (1998) Vomiting and gastroesophageal motor activity in children with disorders of the central nervous system. J Pediatr Gastroenterol Nutr 26:56–63

    Article  CAS  PubMed  Google Scholar 

  2. Penagini F, Mameli C, Fabiano V et al (2015) Dietary intakes and nutritional issues in neurologically impaired children. Nutrients 7:9400–9415

    Article  PubMed  PubMed Central  Google Scholar 

  3. 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 43:331–335

    Article  PubMed  Google Scholar 

  4. 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 29:545–551

    Article  PubMed  PubMed Central  Google Scholar 

  5. 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 49:1742–1745

    Article  PubMed  Google Scholar 

  6. 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 158:650–654

    Article  PubMed  Google Scholar 

  7. Lightdale JR, Gremse DA, Section on Gastroenterology, Hepatology, and Nutrition (2013) Gastroesophageal reflux: management guidance for the pediatrician. Pediatrics 131:e1684–e1695

    Article  PubMed  Google Scholar 

  8. 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–e106

    Article  CAS  PubMed  Google Scholar 

  9. 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 35:173–179

    Article  PubMed  Google Scholar 

  10. Sifrim D (2005) Relevance of volume and proximal extent of reflux in gastro-oesophageal reflux disease. Gut 54:175–178

    Article  CAS  PubMed  PubMed Central  Google Scholar 

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

    Article  CAS  PubMed  Google Scholar 

  12. 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 49:750–756

    Article  PubMed  Google Scholar 

  13. Emerenziani S, Sifrim D (2005) Gastroesophageal reflux and gastric emptying, revisited. Curr Gastroenterol Rep 7:190–195

    Article  PubMed  Google Scholar 

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Acknowledgements

This study was supported by JSPS KAKENHI Grant Number 26462706 [Grant-in-Aid for Scientific Research (C)]. The authors would like to thank Enago (http://www.enago.jp) for the English language review.

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Authors and Affiliations

  1. Department of Pediatric Surgery, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higashi-ku, Hamamatsu, Shizuoka, 431-3192, Japan

    Hisayoshi Kawahara

  2. Department of Pediatric Surgery, Graduate School of Medicine, Osaka University, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan

    Yuko Tazuke & Hiroomi Okuyama

  3. Department of Pediatric Surgery, Osaka Women’s and Children’s Hospital, 840 Murodocho, Izumi, Osaka, 594-1101, Japan

    Hideki Soh & Noriaki Usui

Authors
  1. Hisayoshi Kawahara
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  2. Yuko Tazuke
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  3. Hideki Soh
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  4. Noriaki Usui
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  5. Hiroomi Okuyama
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Corresponding author

Correspondence to Hisayoshi Kawahara.

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The authors declare that they have no conflicts of interest.

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Kawahara, H., Tazuke, Y., Soh, H. et al. Characteristics of gastroesophageal reflux in pediatric patients with neurological impairment. Pediatr Surg Int 33, 1073–1079 (2017). https://doi.org/10.1007/s00383-017-4139-7

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  • DOI: https://doi.org/10.1007/s00383-017-4139-7

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