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Esophageal reflux in symptomatic and asymptomatic infants: postprandial and circadian variations
E Dreizzen1, P Escourrou, M Odievre
1Laboratory of Physiology, Inserm CJF 8909, Hospital A. Béclère, Clamart, France.
Insights
Infants with digestive issues show more frequent and longer esophageal refluxes. Their circadian rhythms of reflux are also more pronounced, aiding in pH monitoring interpretation.
Area of Science:
- Pediatric Gastroenterology
- Digestive Health in Infants
Background:
- Chronic digestive problems in infants are common.
- Esophageal pH monitoring is a key diagnostic tool.
Purpose of the Study:
- To compare esophageal reflux parameters between symptomatic and asymptomatic infants.
- To investigate circadian variations in esophageal reflux in infants.
Main Methods:
- Long-term esophageal pH monitoring (mean 21 hours) in 22 full-term infants.
- Standardized conditions for meals and body position.
- Analysis of reflux frequency, duration, and circadian variations.
Main Results:
- Symptomatic infants had significantly more esophageal refluxes and longer reflux durations.
- Both groups showed circadian variations, but symptomatic infants had higher amplitudes.
- Significant differences in percentage of time with pH < 4 and longest reflux duration were observed.
Conclusions:
- Symptomatic infants exhibit distinct esophageal reflux patterns compared to asymptomatic infants.
- Circadian variations in reflux are more pronounced in symptomatic infants.
- Findings enhance the interpretation of long-term esophageal pH monitoring in infant diagnostics.
Abstract:
Twenty-two full-term infants, nine asymptomatic and 13 symptomatic for chronic digestive problems, had long-term (mean = 21 h) esophageal pH monitoring. All children were observed in strictly standardized conditions including meals and body position. Symptomatic infants presented significantly more esophageal refluxes, spent a greater percentage of time with a pH below 4, had a longer reflux duration (longer clearing time) and presented more refluxes lasting more than 5 min. We performed a determination of the circadian variations of parameters associated with esophageal reflux. Asymptomatic and symptomatic infants presented significant circadian variations of the percentage of time below pH 4 and of the longest duration of reflux. However, symptomatic infants had significantly higher mean values and increased amplitudes of circadian rhythms. Moderate phase lag existed for certain variables between symptomatic and asymptomatic infants. These findings can be helpful when interpreting the results of long-term esophageal pH monitoring.