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Insufficient Body Weight of Adults Born With Esophageal Atresia
Nancy Presse1, Julie Taillefer, Stéphanie Maynard
1*Département de Nutrition, Faculté de Médecine †Faculté de Pharmacie, Université de Montréal ‡Centre de Recherche, Centre Hospitalier de l'Université de Montréal §Service de gastroentérologie, Hôpital St-Luc, Centre Hospitalier de l'Université de Montréal, Montréal, Quebec, Canada.
Insights
Adults born with esophageal atresia (EA) often have insufficient body weight. Digestive issues contribute to being underweight in these patients, necessitating specialized follow-up care.
Area of Science:
- Pediatric Surgery
- Gastroenterology
- Nutritional Science
Background:
- Esophageal atresia (EA) is a congenital condition that can lead to impaired growth in childhood.
- The long-term nutritional status of individuals with EA into adulthood is not well-understood.
- This study investigates the body mass index (BMI) and associated factors in adult EA patients.
Purpose of the Study:
- To determine the BMI of adult patients with EA.
- To identify characteristics associated with underweight in this population.
- To inform clinical management and follow-up strategies for adult EA survivors.
Main Methods:
- A cohort of 40 adult patients with EA was assessed for height and weight to calculate BMI.
- Patients were categorized as underweight if BMI was <18.5 kg/m².
- Statistical analyses compared underweight EA patients to those with normal BMI and the general Quebec population, examining digestive symptoms and eating behaviors.
Main Results:
- 24.3% of adult EA patients were underweight, significantly higher than the Quebec population (2.5%).
- Underweight patients reported more frequent adolescent failure to thrive, severe postprandial fullness, and difficulties swallowing dry foods.
- Key factors associated with underweight included a history of failure to thrive and specific digestive symptoms.
Conclusions:
- Adults with EA exhibit a high prevalence of insufficient body weight.
- Digestive symptoms appear to be a significant contributing factor to underweight status.
- Gastroenterological follow-up and nutritional counseling are recommended for adult EA patients.
Objectives:
Impaired growth has been reported in children born with esophageal atresia (EA). Their nutritional fate at adulthood remains uncertain though. Our objectives were to determine the body mass index (BMI) of adult patients with EA followed up from 2009 to 2011 in the EA clinic of a university-affiliated hospital in Quebec (Canada), and investigate characteristics associated with underweight.
Methods:
The 40 adult patients with EA attending the clinic were invited to participate. Height and weight were measured and BMI calculated. Patients with BMI < 18.5 kg/m were deemed underweight. Patients' characteristics were obtained, including digestive symptoms and compensatory eating behaviors. Nonparametric tests were used to compare the proportion of underweight among patients with EA with that found in the Quebec population and the characteristics between patients with EA deemed underweight and those with BMI ≥ 18.5 kg/m.
Results:
The final sample included 16 women and 21 men, ages 18 to 44 years. Mean BMI was 21.3 ± 4.9 kg/m and 24.3% had BMI < 18.5 kg/m, which is higher than in the Quebec adult population (2.5%, P < 0.001). Compared with patients with EA having BMI ≥ 18.5 kg/m, underweight patients had more often experienced failure to thrive during their adolescence (55.6% vs 7.4%, P = 0.006), and reported severe postprandial fullness (62.5% vs 21.4%, P = 0.040), the need to eat slowly (87.5% vs 46.4%; P = 0.045), and severe difficulties to swallow dry solid foods (50.0% vs 14.3%, P = 0.054).
Conclusions:
Insufficient body weight is prevalent in this sample of adult patients with EA and could result from digestive symptoms. Follow-up with a gastroenterologist and nutritional counseling should be considered for adult patients with EA.
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