Motor function of the esophagus after caustic burn

Area of Science:

• Pediatric Gastroenterology
• Esophageal Motility Disorders
• Gastroesophageal Reflux (GER)

Background:

• Caustic substance ingestion in children can lead to subacute and chronic esophagitis, characterized by stricture, rigidity, and dysphagia.
• Esophageal dysfunction is a common complication following caustic esophageal burns in pediatric populations.

Purpose of the Study:

• To investigate esophageal motor function in children with chronic esophagitis after caustic burns.
• To compare esophageal function in burned children with a control group to identify sequelae of caustic ingestion.

Main Methods:

• Utilized esophageal manometry, radiology, 24-hour pH monitoring, and 99mTc scintigraphy in 25 children with chronic esophagitis post-burn.
• Compared findings with 12 children without gastroesophageal reflux (GER).

Main Results:

• 68% of burned children exhibited esophageal dysfunction, with significantly altered pH monitoring parameters (e.g., prolonged reflux duration).
• Manometry revealed a high percentage of nonpropulsive waves (77%) and reduced Esophageal Work Index.
• Esophageal strictures (60%) and delayed esophageal transit (99mTc scintigraphy) were prevalent, correlating with manometry findings.

Conclusions:

• Motility disturbances and GER are frequent sequelae of caustic esophageal burns in children.
• Findings underscore the importance of evaluating esophageal function and GER in managing pediatric caustic esophagitis.
• Therapeutic strategies, including dietary modifications, should account for these identified motility and reflux issues.