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Effects of Esophageal Acidification on Troublesome Symptoms: An Approach to Characterize True Acid GERD in Dysphagic

Maneesha Sivalingam1, Swetha Sitaram1, Kathryn A Hasenstab1

  • 1Innovative Neonatal and Infant Feeding Disorders Program, Center for Perinatal Research, The Research Institute at Nationwide Children's Hospital, Columbus, OH, USA.

Dysphagia
|April 3, 2017
PubMed

Insights

Acid reflux events reaching the middle or upper esophagus in infants are linked to increased cardiorespiratory symptoms like coughing. This suggests esophageal sensitivity or clearance issues may worsen infant symptoms.

Area of Science:

  • Gastroenterology
  • Neonatology
  • Pediatric Symptomology

Background:

  • Gastroesophageal reflux disease (GERD) is a common concern in neonates.
  • Understanding the relationship between acid reflux extent and symptom generation is crucial for effective management.

Purpose of the Study:

  • To quantify and compare the maximal extent (height) of acid reflux events (AREs) and their impact on symptom generation in dysphagic neonates.
  • To analyze the correlation between ARE height and specific symptoms, as well as temporal characteristics.

Main Methods:

  • 53 dysphagic neonates underwent 24-hour pH-impedance studies.
  • AREs were categorized by maximal refluxate extent (distal, middle, proximal).
  • Symptom correlation and temporal characteristics were analyzed using statistical models.

Main Results:

  • Distal AREs showed increased frequency and decreased acid clearance time.
  • Middle and proximal AREs exhibited longer acid clearance than bolus clearance.
  • Increased odds of cardiorespiratory symptoms (cough, sneeze) were associated with middle and proximal AREs.

Conclusions:

  • Proximal AREs likely trigger protective reflexes, but delays in clearance mechanisms or heightened esophageal sensitivity may exacerbate symptoms.
  • The height of acid reflux events significantly correlates with symptom generation in dysphagic neonates.
  • Further research into esophageal sensitivity and clearance mechanisms is warranted.

Keywords:
Acid refluxDeglutitionDeglutition disordersDysphagiaGERDSwallowing

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