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Food Refusal, Dysphagia, and Odynophagia

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Esophageal and Gastric Disorders in Infancy and Childhood

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Abstract

Food refusal, dysphagia, and odynophagia may represent symptoms of a wide array of underlying anatomical or functional upper aerodigestive disorders along with a behavioral overlay. It is imperative that the specialist has a detailed understanding of the upper aerodigestive tract as this can have an impact on making correct and timely decisions for diagnostic studies and treatment choices. The management of younger children presenting with food refusal or swallowing dysfunction tends to be more challenging, and an interdisciplinary approach is felt to be most effective in addressing this issue.

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References

  1. Dusick A. Investigation and management of dysphagia. Semin Pediatr Neurol. 2003;10(4):255–64.

    Article  PubMed  Google Scholar 

  2. Prasse JE, Kikano GE. An overview of pediatric dysphagia. Clin Pediatr (Phila). 2009;48(3):247–51.

    Article  Google Scholar 

  3. Matson JL, Fodstad JC. Issues in identifying the etiology of food refusal in young children. J Pediatr Gastroenterol Nutr. 2009;48(3):274–5.

    Article  PubMed  Google Scholar 

  4. Logemann JA. Swallowing disorders. Best Pract Res Clin Gastroenterol. 2007;21(4):563–73.

    Article  PubMed  Google Scholar 

  5. Smith CH, Logemann JA, Colangelo LA, Rademaker AW, Pauloski BR. Incidence and patient characteristics associated with silent aspiration in the acute care setting. Dysphagia. 1999;14(1):1–7.

    Article  CAS  PubMed  Google Scholar 

  6. Sheikh S, Allen E, Shell R, et al. Chronic aspiration without gastroesophageal reflux as a cause of chronic respiratory symptoms in neurologically normal infants. Chest. 2001;120(4):1190–5.

    Article  CAS  PubMed  Google Scholar 

  7. Newman LA, Keckley C, Petersen MC, Hamner A. Swallowing function and medical diagnoses in infants suspected of dysphagia. Pediatrics. 2001;108(6), E106.

    Article  CAS  PubMed  Google Scholar 

  8. Lefton-Greif MA, Carroll JL, Loughlin GM. Long-term follow-up of oropharyngeal dysphagia in children without apparent risk factors. Pediatr Pulmonol. 2006;41(11):1040–8.

    Article  PubMed  Google Scholar 

  9. Boesch RP, Daines C, Willging JP, et al. Advances in the diagnosis and management of chronic pulmonary aspiration in children. Eur Respir J. 2006;28(4):847–61.

    Article  CAS  PubMed  Google Scholar 

  10. Vandenplas Y, Rudolph CD, Di Lorenzo C, et al. 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 Pediatr Gastroenterol Nutr. 2009;49(4):498–547.

    Article  PubMed  Google Scholar 

  11. Furuta GT, Liacouras CA, Collins MH, et al. Eosinophilic esophagitis in children and adults: a systematic review and consensus recommendations for diagnosis and treatment. Gastroenterology. 2007;133(4):1342–63.

    Article  CAS  PubMed  Google Scholar 

  12. Pentiuk SP, Miller CK, Kaul A. Eosinophilic esophagitis in infants and toddlers. Dysphagia. 2007;22(1):44–8.

    Article  PubMed  Google Scholar 

  13. Liacouras CA, Spergel JM, Ruchelli E, et al. Eosinophilic esophagitis: a 10-year experience in 381 children. Clin Gastroenterol Hepatol. 2005;3(12):1198–206.

    Article  PubMed  Google Scholar 

  14. Rothenberg ME. Eosinophilic gastrointestinal disorders (EGID). J Allergy Clin Immunol. 2004;113(1):11–28; quiz 9.

    Article  CAS  PubMed  Google Scholar 

  15. Gonsalves N, Policarpio-Nicolas M, Zhang Q, Rao MS, Hirano I. Histopathologic variability and endoscopic correlates in adults with eosinophilic esophagitis. Gastrointest Endosc. 2006;64(3):313–9.

    Article  PubMed  Google Scholar 

  16. Franciosi JP, Liacouras CA. Eosinophilic esophagitis. Immunol Allergy Clin N Am. 2009;29(1):19–27, viii.

    Article  Google Scholar 

  17. Rothenberg ME. Biology and treatment of eosinophilic esophagitis. Gastroenterology. 2009;137(4):1238–49.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  18. Spergel JM, Andrews T, Brown-Whitehorn TF, Beausoleil JL, Liacouras CA. Treatment of eosinophilic esophagitis with specific food elimination diet directed by a combination of skin prick and patch tests. Ann Allergy Asthma Immunol. 2005;95(4):336–43.

    Article  PubMed  Google Scholar 

  19. Spergel JM, Shuker M. Nutritional management of eosinophilic esophagitis. Gastrointest Endosc Clin N Am. 2008;18(1):179–94; xi.

    Article  PubMed  Google Scholar 

  20. Kagalwalla AF, Sentongo TA, Ritz S, et al. Effect of six-food elimination diet on clinical and histologic outcomes in eosinophilic esophagitis. Clin Gastroenterol Hepatol. 2006;4(9):1097–102.

    Article  PubMed  Google Scholar 

  21. Markowitz JE, Spergel JM, Ruchelli E, Liacouras CA. Elemental diet is an effective treatment for eosinophilic esophagitis in children and adolescents. Am J Gastroenterol. 2003;98(4):777–82.

    Article  CAS  PubMed  Google Scholar 

  22. Schaefer ET, Fitzgerald JF, Molleston JP, et al. Comparison of oral prednisone and topical fluticasone in the treatment of eosinophilic esophagitis: a randomized trial in children. Clin Gastroenterol Hepatol. 2008;6(2):165–73.

    Article  CAS  PubMed  Google Scholar 

  23. Aceves SS, Dohil R, Newbury RO, Bastian JF. Topical viscous budesonide suspension for treatment of eosinophilic esophagitis. J Allergy Clin Immunol. 2005;116(3):705–6.

    Article  CAS  PubMed  Google Scholar 

  24. Stein ML, Collins MH, Villanueva JM, et al. Anti-IL-5 (mepolizumab) therapy for eosinophilic esophagitis. J Allergy Clin Immunol. 2006;118(6):1312–9.

    Article  CAS  PubMed  Google Scholar 

  25. Eisenbach C, Merle U, Schirmacher P, et al. Perforation of the esophagus after dilation treatment for dysphagia in a patient with eosinophilic esophagitis. Endoscopy. 2006;38 Suppl 2:E43–4.

    Article  PubMed  Google Scholar 

  26. Sherman PM, Hassall E, Fagundes-Neto U, et al. A global, evidence-based consensus on the definition of gastroesophageal reflux disease in the pediatric population. Am J Gastroenterol. 2009;104(5):1278–95; quiz 96.

    Article  PubMed  Google Scholar 

  27. Salvatore S, Vandenplas Y. Gastro-oesophageal reflux disease and motility disorders. Best Pract Res Clin Gastroenterol. 2003;17(2):163–79.

    Article  PubMed  Google Scholar 

  28. Dent J. Landmarks in the understanding and treatment of reflux disease. J Gastroenterol Hepatol. 2009;24 Suppl 3:S5–14.

    Article  PubMed  Google Scholar 

  29. Berezin S, Medow MS, Glassman MS, Newman LJ. Chest pain of gastrointestinal origin. Arch Dis Child. 1988;63(12):1457–60.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  30. Theodoropoulos DS, Pecoraro DL, Lockey RF, Boyce Jr HW, Bukantz SC. Visceral sensitivity in gastroesophageal reflux. Dig Dis Sci. 2002;47(11):2554–64.

    Article  PubMed  Google Scholar 

  31. Catto-Smith AG, Machida H, Butzner JD, Gall DG, Scott RB. The role of gastroesophageal reflux in pediatric dysphagia. J Pediatr Gastroenterol Nutr. 1991;12(2):159–65.

    Article  CAS  PubMed  Google Scholar 

  32. Jacob P, Kahrilas PJ, Vanagunas A. Peristaltic dysfunction associated with nonobstructive dysphagia in reflux disease. Dig Dis Sci. 1990;35(8):939–42.

    Article  CAS  PubMed  Google Scholar 

  33. Miller-Loncar C, Bigsby R, High P, Wallach M, Lester B. Infant colic and feeding difficulties. Arch Dis Child. 2004;89(10):908–12.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  34. Avidan B, Sonnenberg A, Schnell TG, Sontag SJ. Acid reflux is a poor predictor for severity of erosive reflux esophagitis. Dig Dis Sci. 2002;47(11):2565–73.

    Article  CAS  PubMed  Google Scholar 

  35. Gupta SK, Hassall E, Chiu YL, Amer F, Heyman MB. Presenting symptoms of nonerosive and erosive esophagitis in pediatric patients. Dig Dis Sci. 2006;51(5):858–63.

    Article  PubMed  Google Scholar 

  36. Duca AP, Dantas RO, Rodrigues AA, Sawamura R. Evaluation of swallowing in children with vomiting after feeding. Dysphagia. 2008;23(2):177–82.

    Article  PubMed  Google Scholar 

  37. Sood MR, Rudolph CD. Gastroesophageal reflux in adolescents. Adolesc Med Clin. 2004;15(1):17–36, vii–viii.

    Article  PubMed  Google Scholar 

  38. Moon A, Solomon A, Beneck D, Cunningham-Rundles S. Positive association between Helicobacter pylori and gastroesophageal reflux disease in children. J Pediatr Gastroenterol Nutr. 2009;49(3):283–8.

    Article  PubMed  PubMed Central  Google Scholar 

  39. Arvedson J, Rogers B, Buck G, Smart P, Msall M. Silent aspiration prominent in children with dysphagia. Int J Pediatr Otorhinolaryngol. 1994;28(2–3):173–81.

    Article  CAS  PubMed  Google Scholar 

  40. van Wijk MP, Benninga MA, Omari TI. Role of the multichannel intraluminal impedance technique in infants and children. J Pediatr Gastroenterol Nutr. 2009;48(1):2–12.

    Article  PubMed  Google Scholar 

  41. Woodley FW, Mousa H. Acid gastroesophageal reflux reports in infants: a comparison of esophageal pH monitoring and multichannel intraluminal impedance measurements. Dig Dis Sci. 2006;51(11):1910–6.

    Article  PubMed  Google Scholar 

  42. Gilger MA, El-Serag HB, Gold BD, et al. Prevalence of endoscopic findings of erosive esophagitis in children: a population-based study. J Pediatr Gastroenterol Nutr. 2008;47(2):141–6.

    Article  PubMed  Google Scholar 

  43. Nelson SP, Chen EH, Syniar GM, Christoffel KK. One-year follow-up of symptoms of gastroesophageal reflux during infancy. Pediatric Practice Research Group. Pediatrics. 1998;102(6), E67.

    Article  CAS  PubMed  Google Scholar 

  44. Hyman PE. Gastroesophageal reflux: one reason why baby won’t eat. J Pediatr. 1994;125(6 Pt 2):S103–9.

    Article  CAS  PubMed  Google Scholar 

  45. Tolia V, Bishop PR, Tsou VM, Gremse D, Soffer EF, Comer GM. Multicenter, randomized, double-blind study comparing 10, 20 and 40 mg pantoprazole in children (5–11 years) with symptomatic gastroesophageal reflux disease. J Pediatr Gastroenterol Nutr. 2006;42(4):384–91.

    Article  CAS  PubMed  Google Scholar 

  46. Hoffman I, Tertychnyy A, Ectors N, De Greef T, Haesendonck N, Tack J. Duodenogastro-esophageal reflux in children with refractory gastro-esophageal reflux disease. J Pediatr. 2007;151(3):307–11.

    Article  PubMed  Google Scholar 

  47. Rydell AM, Dahl M. Children with early refusal to eat: follow-up in adolescence. Acta Paediatr. 2005;94(9):1186–91.

    Article  PubMed  Google Scholar 

  48. Paradise JL, Bluestone CD, Bachman RZ, et al. Efficacy of tonsillectomy for recurrent throat infection in severely affected children. Results of parallel randomized and nonrandomized clinical trials. N Engl J Med. 1984;310(11):674–83.

    Article  CAS  PubMed  Google Scholar 

  49. Ungkanont K, Yellon RF, Weissman JL, Casselbrant ML, Gonzalez-Valdepena H, Bluestone CD. Head and neck space infections in infants and children. Otolaryngol Head Neck Surg. 1995;112(3):375–82.

    Article  CAS  PubMed  Google Scholar 

  50. Kosko JR, Moser JD, Erhart N, Tunkel DE. Differential diagnosis of dysphagia in children. Otolaryngol Clin N Am. 1998;31(3):435–51.

    Article  CAS  Google Scholar 

  51. Buchin PJ. Swallowing disorders. Diagnosis and medical treatment. Otolaryngol Clin N Am. 1988;21(4):663–76.

    CAS  Google Scholar 

  52. Rodrigues F, Brandao N, Duque V, Ribeiro C, Antonio AM. Herpes simplex virus esophagitis in immunocompetent children. J Pediatr Gastroenterol Nutr. 2004;39(5):560–3.

    Article  PubMed  Google Scholar 

  53. Wong RC, Abdul-Karim FW. Atypical herpes simplex esophagitis. Gastrointest Endosc. 2005;61(2):291–2.

    Article  PubMed  Google Scholar 

  54. Kikendall JW. Pill esophagitis. J Clin Gastroenterol. 1999;28(4):298–305.

    Article  CAS  PubMed  Google Scholar 

  55. Winstead NS, Bulat R. Pill esophagitis. Curr Treat Options Gastroenterol. 2004;7(1):71–6.

    Article  PubMed  Google Scholar 

  56. Kikendall JW, Friedman AC, Oyewole MA, Fleischer D, Johnson LF. Pill-induced esophageal injury. Case reports and review of the medical literature. Dig Dis Sci. 1983;28(2):174–82.

    Article  CAS  PubMed  Google Scholar 

  57. Litovitz TL, Klein-Schwartz W, White S, et al. 2000 annual report of the American Association of Poison Control Centers Toxic Exposure Surveillance System. Am J Emerg Med. 2001;19(5):337–95.

    Article  CAS  PubMed  Google Scholar 

  58. Kay M, Wyllie R. Pediatric foreign bodies and their management. Curr Gastroenterol Rep. 2005;7(3):212–8.

    Article  PubMed  Google Scholar 

  59. Miller RS, Willging JP, Rutter MJ, Rookkapan K. Chronic esophageal foreign bodies in pediatric patients: a retrospective review. Int J Pediatr Otorhinolaryngol. 2004;68(3):265–72.

    Article  PubMed  Google Scholar 

  60. Sharieff GQ, Brousseau TJ, Bradshaw JA, Shad JA. Acute esophageal coin ingestions: is immediate removal necessary? Pediatr Radiol. 2003;33(12):859–63.

    Article  PubMed  Google Scholar 

  61. Litovitz T, Schmitz BF. Ingestion of cylindrical and button batteries: an analysis of 2382 cases. Pediatrics. 1992;89(4 Pt 2):747–57.

    CAS  PubMed  Google Scholar 

  62. Lao J, Bostwick HE, Berezin S, Halata MS, Newman LJ, Medow MS. Esophageal food impaction in children. Pediatr Emerg Care. 2003;19(6):402–7.

    Article  PubMed  Google Scholar 

  63. Hussain SZ, Thomas R, Tolia V. A review of achalasia in 33 children. Dig Dis Sci. 2002;47(11):2538–43.

    Article  CAS  PubMed  Google Scholar 

  64. Gariepy CE, Mousa H. Clinical management of motility disorders in children. Semin Pediatr Surg. 2009;18(4):224–38.

    Article  PubMed  Google Scholar 

  65. Ganatra JV, Medow MS, Berezin S, et al. Esophageal dysmotility elicited by acid perfusion in children with esophagitis. Am J Gastroenterol. 1995;90(7):1080–3.

    CAS  PubMed  Google Scholar 

  66. Chitkara DK, Fortunato C, Nurko S. Esophageal motor activity in children with gastro-esophageal reflux disease and esophagitis. J Pediatr Gastroenterol Nutr. 2005;40(1):70–5.

    Article  PubMed  Google Scholar 

  67. Nurko S, Rosen R, Furuta GT. Esophageal dysmotility in children with eosinophilic esophagitis: a study using prolonged esophageal manometry. Am J Gastroenterol. 2009;104(12):3050–7.

    Article  PubMed  PubMed Central  Google Scholar 

  68. Werlin SL. Antroduodenal motility in neurologically handicapped children with feeding intolerance. BMC Gastroenterol. 2004;4:19.

    Article  PubMed  PubMed Central  Google Scholar 

  69. Di Lorenzo C, Orenstein S. Fundoplication: friend or foe? J Pediatr Gastroenterol Nutr. 2002;34(2):117–24.

    Article  PubMed  Google Scholar 

  70. Hassall E. Outcomes of fundoplication: causes for concern, newer options. Arch Dis Child. 2005;90(10):1047–52.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  71. Romeo G, Zuccarello B, Proietto F, Romeo C. Disorders of the esophageal motor activity in atresia of the esophagus. J Pediatr Surg. 1987;22(2):120–4.

    Article  CAS  PubMed  Google Scholar 

  72. Nakazato Y, Landing BH, Wells TR. Abnormal Auerbach plexus in the esophagus and stomach of patients with esophageal atresia and tracheoesophageal fistula. J Pediatr Surg. 1986;21(10):831–7.

    Article  CAS  PubMed  Google Scholar 

  73. Davies MR. Anatomy of the extrinsic motor nerve supply to mobilized segments of the oesophagus disrupted by dissection during repair of oesophageal atresia with distal fistula. Br J Surg. 1996;83(9):1268–70.

    Article  CAS  PubMed  Google Scholar 

  74. Romeo C, Bonanno N, Baldari S, et al. Gastric motility disorders in patients operated on for esophageal atresia and tracheoesophageal fistula: long-term evaluation. J Pediatr Surg. 2000;35(5):740–4.

    Article  CAS  PubMed  Google Scholar 

  75. Stringer MD, Oldham KT, Mouriquand PDE. Pediatric surgery and urology: long-term outcomes. 2nd ed. Cambridge: Cambridge University Press; 2006.

    Book  Google Scholar 

  76. Martin GR, Rudolph C, Hillemeier C, Heyman MB. Dysphagia lusorum in children. Am J Dis Child. 1986;140(8):815–6.

    CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. Division of Gastroenterology Hepatology and Nutrition, Cincinnati Children’s Hospital Medical Center, 3333 Burnet Avenue, MLC 2010, Cincinnati, OH, 45229, USA

    Amy Tsai MD, Jose Garza MD & Ajay Kaul MD

Authors
  1. Amy Tsai MD
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  2. Jose Garza MD
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  3. Ajay Kaul MD
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Corresponding author

Correspondence to Ajay Kaul MD .

Editor information

Editors and Affiliations

  1. Medical University of Graz, Graz, Austria

    Holger Till

  2. Sheffield Children’s Hospital, Paediatric Gastroenterology Centre, Sheffield, United Kingdom

    Mike Thomson

  3. Division of Cardiothoracic Surgery, Department of Surgery, University of Minnesota Medical School, Minneapolis, Minnesota, USA

    John E. Foker

  4. Department Surgery, University of Missouri, Kansas City Children’s Mercy Hospital, Kansas City, Missouri, USA

    George W. Holcomb III

  5. University of Arizona, Tucson, Arizona, USA

    Khalid M. Khan

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Tsai, A., Garza, J., Kaul, A. (2017). Food Refusal, Dysphagia, and Odynophagia. In: Till, H., Thomson, M., Foker, J., Holcomb III, G., Khan, K. (eds) Esophageal and Gastric Disorders in Infancy and Childhood. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-11202-7_103

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  • DOI: https://doi.org/10.1007/978-3-642-11202-7_103

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