Seizure disorder as a risk factor for gastroesophageal reflux in children with neurodevelopmental disabilities

Area of Science:

• Pediatric Surgery
• Gastroenterology
• Neurodevelopmental Disabilities

Background:

• Gastroesophageal reflux (GER) development post-gastrostomy in children with severe neurodevelopmental disabilities is understudied.
• Gastrostomy tubes are common interventions for feeding in this population.

Purpose of the Study:

• To investigate the incidence of GER requiring intervention after gastrostomy placement in children with severe neurodevelopmental disabilities.
• To identify risk factors associated with the development of GER post-gastrostomy.

Main Methods:

• Retrospective review of medical records for 102 children who underwent gastrostomy between 1987 and 1997.
• Analysis of neurologically related diagnoses, reflux diagnostic tests, and re-admission data within two years.
• Comparison of outcomes between patients who received a gastrostomy tube alone versus those who had a simultaneous antireflux procedure.

Main Results:

• Of 30 patients with follow-up data who received a gastrostomy tube alone, 7 (23%) required antireflux surgery within two years.
• Children with a seizure disorder had a significantly higher risk (over 4-fold) of requiring re-admission for antireflux surgery compared to other patients (57% vs. 13%, P=0.03).

Conclusions:

• A seizure disorder is a significant risk factor for developing symptomatic gastroesophageal reflux requiring surgical intervention after gastrostomy placement in children with severe neurodevelopmental disabilities.
• This finding highlights the importance of considering concurrent antireflux procedures in neurologically impaired children with seizure disorders undergoing gastrostomy.