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Gastroesophageal Reflux in Children pp 27–49Cite as

Esophageal Clearance in Gastroesophageal Reflux

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Abstract

Gastroesophageal reflux is a normal physiologic process, with multiple mechanisms in place to prevent physiologic reflux from becoming pathologic. One such mechanism is esophageal clearance. Esophageal clearance is composed of two distinct phases: volume clearance and chemical clearance. Volume clearance utilizes swallowing and esophageal peristalsis to empty the esophagus of reflux bolus and virtually all acid. Chemical clearance neutralizes the residual acid film by saliva, either swallowed or secreted by the esophagus. Combined pH-multichannel intraluminal impedance is the best technique to measure both phases of clearance. Normal values for children have been established. If either phase of esophageal clearance is prolonged, the esophagus experiences increased acid exposure, and this can result in secondary complications. There are physiologic and disease states which can impact either or both of the clearance phases. They do so by impacting the swallow, esophageal peristalsis, esophageal motility, and composition or quantity of saliva. As a result, these patients are predisposed to gastroesophageal reflux disease.

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Change history

  • 05 September 2018

    An erratum has been published.

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Authors and Affiliations

  1. Department of Pediatric Gastroenterology, University of California, San Diego, CA, 92123, USA

    Maheen Hassan & Hayat Mousa

  2. Department of Pediatric Gastroenterology, Nationwide Children’s Hospital, Columbus, OH, 43205, USA

    Frederick W. Woodley

  3. Department of Pediatrics, The Ohio State University College of Medicine, Columbus, OH, 43205, USA

    Frederick W. Woodley

Authors
  1. Maheen Hassan
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  2. Frederick W. Woodley
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  3. Hayat Mousa
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Correspondence to Hayat Mousa .

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Editors and Affiliations

  1. Universitair Ziekenhuis Brussel, Kidz Health Castle, Brussels, Belgium

    Yvan Vandenplas

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Hassan, M., Woodley, F.W., Mousa, H. (2017). Esophageal Clearance in Gastroesophageal Reflux. In: Vandenplas, Y. (eds) Gastroesophageal Reflux in Children. Springer, Cham. https://doi.org/10.1007/978-3-319-60678-1_3

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