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Esophageal aperistalsis due to reflux esophagitis: a report of two cases
S Cucchiara1, A Staiano, F M Paone
1Department of Pediatrics, Second School of Medicine, University of Naples, Italy.
Insights
Severe esophagitis in infants can disrupt esophageal motility, causing aperistalsis and low-amplitude waves. Treatment with H2 antagonists improved symptoms and normalized esophageal function.
Area of Science:
- Pediatric Gastroenterology
- Esophageal Motility Disorders
- Gastrointestinal Physiology
Background:
- Gastroesophageal reflux disease (GERD) and esophagitis are common in infants.
- Esophageal motility plays a crucial role in preventing reflux and clearing the esophagus.
- Abnormalities in esophageal function can exacerbate GERD and esophagitis.
Observation:
- Two infants presented with severe esophagitis and gastroesophageal reflux disease.
- Esophageal manometry demonstrated significant motor abnormalities, including aperistalsis and simultaneous low-amplitude contractions.
- One infant also exhibited defective lower esophageal sphincter relaxation.
Findings:
- Short-term, intensive treatment with H2 antagonists led to symptomatic and endoscopic improvement.
- Manometric normalization was observed following H2 antagonist therapy.
- These findings suggest a potential link between severe esophagitis and impaired esophageal motility control.
Implications:
- Severe esophagitis may compromise the neural control mechanisms governing esophageal motility.
- This disruption can lead to discoordination and reduced amplitude of esophageal contractions.
- Understanding this relationship can inform therapeutic strategies for pediatric GERD and associated motility issues.
Abstract:
Two small infants with gastroesophageal reflux disease and esophagitis are reported. Esophageal manometry revealed in both patients severe abnormalities consisting of aperistalsis and simultaneous low-amplitude motor waves. In one of the patients, defective relaxation of lower esophageal sphincter was also noted. Short-term intensive treatment with H2 antagonists resulted in symptomatic and endoscopic improvement as well as in manometric normalization. It is suggested that severe esophagitis may affect control mechanisms of esophageal motility, resulting in loss of coordination and decreased amplitude of contractions.