Severe gastrooesophageal reflux disease associated with foetal alcohol syndrome

Area of Science:

• Obstetrics and Gynecology
• Pediatric Gastroenterology
• Developmental Toxicology

Background:

• Prenatal alcohol exposure (PAE) is linked to fetal growth restriction, craniofacial anomalies, and CNS dysfunction.
• While PAE's neurotoxic effects are known, its impact on the developing gastrointestinal (GI) tract remains poorly understood.
• Existing literature includes limited case reports associating fetal alcohol syndrome (FAS) with GI neuropathy.

Purpose of the Study:

• To report a rare association between fetal alcohol syndrome (FAS) and severe gastroesophageal reflux disease (GERD).
• To illustrate the potential for significant GI complications beyond CNS effects in PAE.
• To emphasize the need for considering GI sequelae in infants with PAE.

Main Methods:

• Case report of an infant diagnosed with FAS.
• Detailed clinical history focusing on gastrointestinal symptoms and treatment responses.
• Documentation of failure to thrive despite maximal medical and nutritional interventions.

Main Results:

• The infant presented with severe gastroesophageal reflux disease (GERD).
• The condition was refractory to standard medical treatments (domperidone, omeprazole), high-calorie feeds, PEG feeding, and parenteral nutrition.
• Surgical intervention (fundoplication) was ultimately required to improve growth and nutritional status.

Conclusions:

• This case underscores that the adverse effects of prenatal alcohol exposure extend beyond the central nervous system to the gastrointestinal tract.
• Severe GI complications, such as refractory GERD, can occur in infants with FAS.
• Early recognition and management of potential GI sequelae are crucial for optimizing outcomes in affected infants.