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Gastroesophageal reflux in children: an underrated disease
Insights
Gastroesophageal reflux in children can cause serious health issues. The Nissen fundoplication surgery effectively treated 14 patients with severe reflux symptoms, showing low complication rates.
Area of Science:
- Pediatric Surgery
- Gastroenterology
Background:
- Gastroesophageal reflux is a complex condition in infants and children.
- It can lead to severe symptoms including vomiting, failure to thrive, respiratory issues, and esophagitis.
- Reflux is often unresponsive to medical management, particularly in cases of esophageal atresia and neurologic disease.
Purpose of the Study:
- To evaluate the diagnostic methods and surgical outcomes for pediatric gastroesophageal reflux.
- To assess the effectiveness of Nissen fundoplication in managing severe cases.
Main Methods:
- Diagnosis involved detailed history, barium swallow, radionuclide milk scan, and endoscopy with biopsy.
- The Nissen fundoplication procedure was performed on all 14 operative patients.
Main Results:
- The study included 14 patients with symptoms like intractable vomiting, failure to thrive, recurrent pneumonia, apnea, asthma, esophagitis, and stricture.
- Nissen fundoplication demonstrated effectiveness with low morbidity and recurrence rates.
- The procedure addressed significant mortality risks associated with severe apnea and morbidity from esophagitis.
Conclusions:
- Nissen fundoplication is an effective surgical treatment for severe pediatric gastroesophageal reflux.
- Early diagnosis and surgical intervention can mitigate serious health complications and psychosocial disruption.
Abstract:
Gastroesophageal reflux in infants and children is a complex disease. The diagnosis in 14 operative patients was made utilizing a careful history, barium swallow, technetium radionuclide milk scan, and endoscopy with esophageal biopsy. Symptoms were intractable vomiting, failure to thrive, recurrent pneumonia, apnea, asthma and bronchitis, esophagitis, and esophageal stricture. The pernicious aspects of this disease include a potentially significant mortality in children with severe apnea episodes, increased morbidity with esophagitis, and psychosocial disruption for those children that progress to the teenage years with recurrent vomiting, rumination, heartburn and stricture formation. A high incidence of gastroesophageal reflux unresponsive to medical management was noted with esophageal atresia and neurologic disease. The Nissen fundoplication was used in all patients and proved an effective procedure with a low morbidity and recurrence rate.