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[Functional study of gastroesophageal reflux in children with brain diseases]
Insights
Motor disturbances significantly contribute to severe gastro-oesophageal reflux (GER) in brain-damaged children. Impaired esophageal motility and reduced lower esophageal sphincter pressure are key factors in this patient group.
Area of Science:
- Gastroenterology
- Pediatric Neurology
- Esophageal Motility Disorders
Context:
- Gastro-oesophageal reflux (GER) is prevalent in brain-damaged children, often leading to severe esophagitis.
- The underlying mechanisms, particularly esophageal motor function, require further elucidation in this population.
Purpose:
- To investigate the role of esophageal motor abnormalities in the pathogenesis of GER in brain-damaged children.
- To assess lower esophageal sphincter pressure (LESP) and esophageal wave patterns in these patients.
Summary:
- Studied 16 brain-damaged children with GER and esophagitis.
- Found significantly decreased LESP (8.84 mmHg vs. 18.33 mmHg) and increased non-propulsive waves (70% vs. 6.25%) in basal conditions compared to controls.
- Esophageal motility remained impaired after serum and acid instillation challenges.
Impact:
- Demonstrates that esophageal motor disturbances are a primary driver of GER severity in brain-damaged children.
- Highlights the need for targeted interventions addressing motility issues in managing GER in this vulnerable group.
Abstract:
Aiming to evaluate the participation of oesophageal motor troubles in the pathogeny of gastro-oesophageal reflux in brain-damaged children, we have studied 16 of these patients. Most of them had a more or less severe esophagitis due to excessive acid exposure. We have found a decreased LESP as compared to normal subjects (8.84 +/- 6.20 vs. 18.33 +/- 6.55 mmHg (p less than 0.001)), and high percentages of non-propulsive waves in basal conditions (70 +/- 29.66 vs. 6.25 +/- 9.16 (p less than 0.001)) as well as after serum (66.33 +/- 28.06 vs. 16.66 +/- 13.66 (p less than 0.001) and acid instillation (58.33 +/- 28.91 vs. 26.41 +/- 12.04 (p less than 0.05)). These results demonstrate that motor disturbances are responsible for the severity of GER in this group of patients.