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Esophageal motor dysfunction persists in children after surgical cure of reflux: an ambulatory manometric study

J Godoy1, J A Tovar, Y Vicente

  • 1Department of Surgery, Hospital Infantil "La Paz," Universidad Autónoma, Madrid, Spain.

Journal of Pediatric Surgery
|August 31, 2001
PubMed

Insights

Esophageal dysmotility in children with gastroesophageal reflux (GER) persists after fundoplication surgery. This suggests that the observed motor dysfunction may be a primary condition rather than acquired.

Area of Science:

  • Pediatric Gastroenterology
  • Esophageal Motility Disorders
  • Gastroesophageal Reflux Disease (GERD)

Background:

  • Gastroesophageal reflux (GER) in children can be associated with esophageal dysmotility.
  • This dysmotility may be either a primary condition or acquired due to reflux.

Purpose of the Study:

  • To investigate the nature of esophageal motor dysfunction in children with GER.
  • To determine if this dysmotility improves following surgical correction of GER.

Main Methods:

  • Combined ambulatory pH-metry and manometry were used in 16 children with reflux.
  • Measurements were taken before and after successful fundoplication surgery.
  • Paired statistical tests were employed to compare pre- and post-operative manometric and pH-metric variables.

Main Results:

  • Fundoplication successfully resolved GER clinically and pH-metrically in all patients.
  • Esophageal wave frequency decreased significantly post-surgery.
  • Wave amplitude and duration remained unchanged; peristaltic wave proportion was normal and stable.
  • Proportions of complete and effective esophageal waves remained low and did not improve after surgery.

Conclusions:

  • Children with GER exhibit mild esophageal peristaltic disturbances, characterized by incomplete, weak, and ineffective waves.
  • The persistence of esophageal dysmotility after successful fundoplication suggests a primary etiology.
  • Surgical cure of GER does not appear to resolve the underlying esophageal motor dysfunction.
Abstract

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