Abstract
Gastro-oesophageal reflux (GOR) occurs frequently in young children and whilst in some is trivial, in others the consequences may be life threatening. The cause of the different clinical patterns may be related to the underlying motor events. We studied swallow induced motor activity of the oesophageal body and lower sphincter and intra-oesophageal pH in controls (C n=9), infants with GOR without oesophagitis (R n=12) and in GOR with oesophagitis (RO n=5) using a constantly perfused multilumen catheter with distal sleeve and intraluminal pH probe. Basal lower oesophageal sphincter pressure (LOSP) in C was 22.9±3.9 rimHg (mean ±ISD), in R 21.8±11.2 and RO 14±6.5 (p<0.01). The mean amplitude of oesophageal peristaltic waves was C 71.5±15.8, R 50.4±23.2 and RO 15.8±7.9 nrnHg (p<0.01). Tne waveforms in RO only were bizarre and polyphasic. 77 episodes of reflux in GOR were detected, 61 (79%) were synchronous with swallowing and 16 (21%) were Asynchronous with swallowing, and in these^clearance of refluxed acid was longer than in those with synchronous reflux (1.58±1.49 vs 0.75±0.45 min). Asynchronous reflux occurred almost exclusively in those with severe feeding problems or complicated reflux. This study shows that a variety of mechanisms may cause GOR. Decreased basal LOSP occurred in RO. The motor pattern in RO suggests a neuropathic aetiology. Infants with GOR and trivial symptoms had GOR synchronous with swallowing whereas those with serious symptoms had slower acid clearance and asynchronous reflux. We suggest that the former is an exaggerated physiological response and that the latter may be related to intrinsic pathology of the motor apparatus.
Article PDF
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Mahony, M., Spitz, L. & Milla, P. 52. DISORDERED OESOPHAGEAL MOTOR ACTIVITY IN GASTRO-OESOPHAGEL REFLUX. Pediatr Res 22, 104 (1987). https://doi.org/10.1203/00006450-198707000-00073
Issue Date:
DOI: https://doi.org/10.1203/00006450-198707000-00073