Esophageal motility in children with suspected gastroesophageal reflux disease

Area of Science:

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

Background:

• Gastroesophageal reflux disease (GERD) in adults is associated with esophageal motility abnormalities.
• Limited data exists on esophageal body motility in pediatric GERD patients.
• Understanding these patterns is crucial for diagnosis and management in children.

Purpose of the Study:

• To investigate esophageal motility patterns in children diagnosed with GERD.
• To assess the influence of age, anatomical abnormalities, and neurological impairment on motility.
• To correlate manometric findings with GERD severity markers like acid exposure and esophagitis.

Main Methods:

• A cohort of children with severe GERD symptoms underwent comprehensive evaluation.
• Diagnostic tools included barium swallow, upper endoscopy, pH monitoring, and stationary water-perfused esophageal manometry.
• Data was analyzed considering age, presence of anatomical defects, and neurological status.

Main Results:

• Lower esophageal sphincter (LES) pressure and esophageal wave velocity decreased significantly with increasing age in pediatric GERD patients.
• Children with a history of esophageal atresia exhibited severely disturbed esophageal motility.
• Patients with psychomotor retardation showed significantly reduced peristaltic wave occurrence and propagation velocity.
• No significant differences in manometric findings were observed based on pH monitoring results or the presence of esophagitis.

Conclusions:

• Esophageal motility, including LES pressure and wave propagation velocity, diminishes with age in children with GERD.
• Esophageal manometry reveals severe impairments in children with esophageal atresia and psychomotor retardation.
• Esophageal motor abnormalities in pediatric GERD are not directly correlated with endoscopic esophagitis or abnormal acid exposure.