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Gastro-oesophageal reflux in infancy
1Department of Child Health, University of Indonesia, Jakarta.
Insights
Gastro-oesophageal reflux (GOR) in infants can cause various symptoms. Oesophageal pH monitoring helps quantify acid reflux but data interpretation is complex due to multiple influencing factors.
Area of Science:
- Pediatric Gastroenterology
- Infant Health
- Digestive Disorders
Background:
- Gastro-oesophageal reflux (GOR) is common in infants, presenting with or without symptoms.
- While regurgitation is frequent, infants can exhibit diverse symptoms, and oesophagitis is linked to increased oesophageal acid exposure.
- Reflux disease arises from an imbalance in factors affecting GOR, where cause and effect can be cyclical.
Purpose of the Study:
- To explore the complexities of gastro-oesophageal reflux (GOR) in infants.
- To discuss the role and interpretation challenges of oesophageal pH monitoring in diagnosing reflux disease.
- To highlight factors influencing GOR and its management.
Main Methods:
- Utilized oesophageal pH monitoring with a semi-disposable monocrysant antimony pH catheter featuring three sensors.
- Documented oesophageal acidification and gastric buffering to quantify acid reflux frequency and duration.
- Analyzed the complexity of pH monitoring data influenced by factors like infant position, activity, feeding, and medication.
Main Results:
- Oesophageal pH monitoring effectively documents oesophageal acidification and gastric buffering.
- Quantification of acid reflux frequency and duration is achievable through pH monitoring.
- Interpretation of pH data is complex due to numerous influencing factors.
Conclusions:
- Oesophageal pH monitoring is a valuable tool for quantifying acid reflux in infants.
- The interpretation of pH monitoring data requires careful consideration of various confounding factors.
- Future research may find the duration of gastric acid buffering during pH monitoring to be a significant interpretive factor.
Abstract:
Gastro-oesophageal reflux (GOR) is a common phenomenon in infants, which may occur with or without accompanying symptoms. Although most infants presenting with regurgitation have a normal physical examination, it is now recognized that infants may also present with a wide variety of symptoms. Oesophagitis is associated with increased oesophageal acid exposure. The determination of cause and effect is difficult, as there are many aspects of reflux disease where cause and effect relationships are cyclic. Reflux disease is present when there is an imbalance between a number of factors that can contribute to a decrease, as well as an increase, of GOR. Oesophageal pH monitoring with a semi-disposable monocrysant antimony pH catheter with three sensors is very good at documenting oesophageal acidification and gastric buffering and, therefore, quantifies acid reflux frequency and duration. However, the interpretation of the data is complex as they are influenced by numerous factors, such as position, activity (sleep, crying), feeding (frequency and composition) or medication. The duration of buffering of gastric acidity during pH monitoring might, in the future, appear to be a relevant factor in the interpretation of oesophageal pH data.