Abstract
Background: Gastroesophageal reflux disease (GERD) in newborn is characterized by a protean symptomatology that includes excessive irritability and crying, frequent vomiting and regurgitations, feeding problems, rumination, apnea, aspiration pneumonia, failure to thrive and anemia. The aim of this study was to investigate the relationship between symptoms and gastroesophageal activity in infants with gastroesophageal reflux.
Methods: To evaluate gastroesophageal tract activity we have combined multichannel intraluminal electrical impedance (MII) and pH monitoring with epigastric impedance (EGI) in 30 neonates with suspected GERD. This combination of three methods provides complementary, simultaneous data from the esophagus and stomach. MII detected reflux episodes were characterized by time of occurrence, duration, height, pH, gastric filling state and gastric emptying velocity. Relations between GER features, gastric emptying data and symptoms observed during the trial were statistically evaluated.
Results: During 90 hours of combined recording 248 reflux events (15.3% acid) were detected in 30 neonates. 99 episodes were associated to symptoms. The average (SD) gastric emptying time was 148.2(21.9) minutes with a T½ of 56.2(15.1) minutes. The main gastric emptying velocity was 0.69(0.12) radians. The number of GER and acid GER per tracing were respectively 8.3(1.0) and 1.3(0.8). Crying(24) was associated to long and acid reflux events. Regurgitations(13) and vomiting(8) were associated to high level of GER and gastric filling level. Rumination(31) was increased during high level GERs. Irritability(20) was observed in both: low level and high duration reflux episodes. In the end a correlation between apnea(3) and acid refluxes was observed.
Conclusions: Our data suggest a relationship between GER symptoms and gastroesophageal activity. These findings could be relevant to practice of giving neonatal GERD therapeutic treatments on the grounds of infants symptoms. Further studies are necessary to establish the impact of our results and a possible clinical utilization.
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Cresi, F., Savino, F., Marinaccio, C. et al. 72 Relevance of Symptoms Versus Objective Evidences in Neonatal Gastroesophageal Reflux Disease. Pediatr Res 58, 366 (2005). https://doi.org/10.1203/00006450-200508000-00101
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DOI: https://doi.org/10.1203/00006450-200508000-00101