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Value of esophageal manometric studies in the gastroesophageal reflux of infancy

A R Euler, M E Ament

    Pediatrics
    |January 1, 1977
    PubMed

    Insights

    Infants with gastroesophageal reflux (GER) and low lower esophageal sphincter (LES) pressure may require surgery. Manometric studies are crucial for diagnosing GER in infants.

    Area of Science:

    • Pediatric Gastroenterology
    • Gastrointestinal Motility Studies

    Background:

    • Gastroesophageal reflux (GER) is common in infants.
    • Medical management for GER includes thickened feedings and maintaining an upright position.
    • Some infants do not respond to conservative GER treatment.

    Purpose of the Study:

    • To evaluate the role of esophageal manometric studies in infants with GER symptoms.
    • To determine if lower esophageal sphincter (LES) pressure differentiates infants who respond to medical management from those requiring surgery.

    Main Methods:

    • Esophageal manometric studies were performed on 15 infants with GER symptoms.
    • Infants were treated with thickened feedings and continuous upright positioning for three weeks.
    • Surgical intervention (Nissen fundoplication) was performed on infants who failed medical management.

    Main Results:

    • Six infants who underwent Nissen fundoplication had a mean LES pressure of 12.7 mm Hg.
    • Nine infants who responded to medical management had a mean LES pressure of 19.6 mm Hg.
    • The difference in mean LES pressure between the two groups was statistically significant (P < .001).

    Conclusions:

    • Lower esophageal sphincter (LES) pressure is significantly lower in infants with GER who fail medical management and require surgery.
    • Esophageal manometric studies, specifically measuring LES pressure, should be an integral part of evaluating infants with chronic GER symptoms.
    • Manometry can help identify infants who may benefit from surgical intervention over continued medical therapy.

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