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Query: UMLS:C0017168 (gastroesophageal reflux disease)
 11,783 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

This paper describes 62 cases of peptic complications due to gastro-oesophageal reflux in infants and children at the Children's Hospital in Tunis over a 20 years period. The age of the patients ranged from 6 months to 14 years with a majority of males. Failure to thrive, anemia and respiratory complications were the most common features. Upper gastro-intestinal series and endoscopy were performed in all patients and showed the presence of associated hiatus hernia in 53 patients, oesophagitis in 62 and oesophageal stricture in 33. All patients had a primary course of medical treatment. Fifty-three patients required Nissen's fundoplication. Thirty-one patients required oesophageal dilatation. A complete cure of the structures was achieved in all patients but 7. In the whole series, 4 children died.
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PMID:[Peptic complications of gastroesophageal reflux in children. Apropos of 62 cases]. 319 64

We present a male infant with r(9) and del(9p) mosaicism and chromosome constitution of 46,XY,r(9) (p22;q34)/46,XY,del(9) (p22). This patient also had gastroesophageal reflux with persistent regurgitation and resultant failure to thrive. The association of this syndrome with gastroesophageal reflux is emphasized.
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PMID:A case of ring (9)/del(9p) mosaicism associated with gastroesophageal reflux. 145

Seventy-one extended multiple-level esophageal pH studies were performed in 61 infants and children suspected of having gastroesophageal reflux (GER). The patients were placed in one of six clinical groups based on their presenting symptomatology. They were classified as "normals" or "refluxers" based on a reflux score calculated from a pediatric modification of the Johnson and DeMeester distal esophageal pH criteria. For the total group, excluding postoperative patients, all differences noted in the distal esophagus between normals and refluxers persisted at the middle and proximal esophageal levels (P less than .001). Significant differences between normal and reflux patients were noted at all levels in the central nervous system damage and postoperative groups. Only the middle esophageal probe detected differences for all variables in the failure to thrive group (P less than .01). In the esophageal atresia group the middle level sensor detected differences in all parameters studied and the proximal sensor noted differences in three of the four parameters (P less than .01). Significant differences between normals and refluxers in the apnea group were best demonstrated in the proximal esophagus. There was no benefit in monitoring the pH of the more proximal esophageal levels in patients with esophagitis. Extended four-channel esophageal pH studies were highly effective in detecting clinically important GER. The patterns of reflux in infants and children vary markedly with the presenting symptoms. Distal esophageal pH monitoring may not demonstrate evidence of GER that would otherwise be detected by the middle and proximal esophageal sensors. This new ambulatory outpatient technique of pH monitoring in young patients suspected of having GER provides advantages over the conventional esophageal pH study.
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PMID:Extended four-channel esophageal pH monitoring: the importance of acid reflux patterns at the middle and proximal levels. 335 25

The upper-gastrointestinal examinations of 32 patients (mean age, 11 years) with histologically proven Barrett's esophagus were reviewed to evaluate the radiologic findings in children. All patients had symptoms of chronic gastroesophageal reflux and/or esophagitis, including atypical findings such as aspiration pneumonia, seizures, and failure to thrive. Fourteen patients had other diseases that might predispose them to abnormal esophageal motility and gastroesophageal reflux. Twenty-five patients had single-contrast and seven patients had double-contrast examinations. Four patients had normal single-contrast studies; 24 had gastroesophageal reflux; 12 had strictures; 10 had esophageal ulcers; and only four had hiatal hernias. The most notable difference between the results of endoscopy and the upper-gastrointestinal studies was the rate of detection of esophageal ulcers. Ten of the patients with single-contrast studies had ulcers seen at endoscopy but not shown radiologically. No specific radiologic signs of Barrett's esophagus were found, although most of our patients had abnormal upper gastrointestinal studies.
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PMID:Radiographic findings in children and young adults with Barrett's esophagus. 349 14

We describe 9 infants (ranging from 1 to 6 1/2 months) in whom a surgical pathology (gastro-esophageal reflux and/or pyloric stenosis) was associated with cow's milk intolerance (CMI). In all cases vomiting and/or failure to thrive did not disappear after surgery. The patients recovered only after dietary manipulation by cow's milk protein free diet. In 5 out of 9 cases, multiple food intolerances were present (soy and/or casein hydrolysates). In all cases the diagnosis of CMI was confirmed by challenge test. The connections between CMI and abdominal surgery in infancy are discussed.
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PMID:Cow's milk intolerance and abdominal surgery: a puzzling connection. 358 70

A retrospective study was carried out of children undergoing Nissen fundoplication and pyloroplasty for the correction of gastro-oesophageal reflux. Twenty children (thirteen males, seven females) aged 8 months to 12 years underwent surgery over a 10 year period. Forty per cent were mentally retarded. Presentation was failure to thrive in 19 (95 per cent), recurrent vomiting in 18 (90 per cent) and haematemesis in 14 (70 per cent). Four children had Barrett's oesophagus. There were no operative or perioperative mortalities. Follow-up (mean period 3 years, 9 months) revealed no further symptoms of reflux. The 'normal' children gained weight postoperatively whereas the 'retarded' group did not. Adhesion obstruction (10 per cent) was the major late postoperative complication. Regression of Barrett's epithelium was noted endoscopically. 'Gas-bloat' syndrome, a major complication following fundoplication, was not encountered.
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PMID:Nissen fundoplication and pyloroplasty in the management of gastro-oesophageal reflux in children. 360 5

A retrospective study based upon 100 consecutive antireflux operations performed in children for gastroesophageal reflux (GER) in the last 9 years enables the authors to elaborate on indications and their timing. The clinical pictures, often combined in this series, were vomiting (85%), respiratory disease (50%), failure to thrive (47%), haemorrhage (25%), brain damage (16%), rumination (6%), oesophageal stenosis (4%), torticollis (3%) and cricopharyngeal dysphagia (1%). Five children had been previously operated upon for oesophageal atresia. Hiatal hernia was found in only 10 instances. Only 9 children were operated upon before the age of 12 months. Overall operative age was high (52.5 months) and that of patients with neurologic disease was even higher (81.3 months) probably as a result of delayed diagnosis. This experience underlines the limitations of medical treatment beyond the age of 12 months, the poor reliability of disappearance of vomiting as an index of cure during the first year and the need for facing operative indications without prejudgements based on traditional ideas that do not take into consideration clinical manifestations of GER disease which are currently well established.
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PMID:[Indications for the surgery of gastroesophageal reflux in children]. 363 70

Dysfunction of the upper esophageal sphincter was found in five out of 44 children with gastroesophageal reflux. Three of the five children had mental retardation associated with Silver Russell syndrome, 5p syndrome, or minimal change myopathy. The five patients had swallowing disorders, vomiting, and failure to thrive; four also had pulmonary aspiration. Esophageal manometry showed incomplete upper esophageal sphincter relaxation in two patients, upper esophageal sphincter relaxation incoordinated with pharyngeal contractions in two other patients, and both incomplete and incoordinated upper esophageal sphincter relaxation in the last patient. Intensive and successful treatment of gastroesophageal reflux did not improve swallowing or symptoms of pulmonary aspiration in four children. The fifth patient underwent cricopharyngeal myotomy, with complete resolution of respiratory and swallowing symptoms. It is suggested that a dysfunction of the upper esophageal sphincter, either primary or secondary to neuromuscular disorders, may play a role in the swallowing disorders and respiratory symptoms of pediatric patients.
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PMID:Disorders of upper esophageal sphincter motility in children. 368 74

Thirty five severely mentally retarded children with significant gastro-esophageal reflux were submitted to surgical treatment. The age range was 2 months to 13 years. Characteristics and presenting symptoms were chronic vomiting (62%), merycism (43%), gastro-intestinal blood loss (37%), recurrent pneumonia (65%) and failure to thrive (57%). Barium esophagogram demonstrated free gastro-esophageal reflux in all patients with an associated hiatus hernia being noted in 3 cases. An upper gastro-intestinal endoscopy was performed in 24 children. Esophagitis of 2 or 3 degrees was present in 16 cases. A standard medical treatment was used in all patients during 1 month to 3 years. The patients were referred for surgery because they had no response to medical management or they had hiatus hernia or esophagitis type II or III. The operative procedure performed was Nissen fundoplication without gastrostomy. The mean duration of follow-up was 5 years (range 6 months to 12 years). We have not reviewed 5 patients. Several post-operative complications occurred: 4 pneumonia (2 deaths), 2 small bowel obstructions, 4 dumping syndrome and 1 death without etiology. Late complications were important too: 6 persistent reflux, 2 small bowel obstructions (2 deaths) and 2 peritonitis (2 deaths). Three patients died of their brain damage during the study period, 6 months to 8 years following their surgical procedure. The authors insist on: The frequency of gastro-esophageal reflux in retardates with a frequent merycism associated. The search for this reflux must be systematically done because it provokes some respiratory problems and a bad general status which distressed the child but also the family or the institution caring for the child.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Nissen's operation in children with brain diseases]. 376 12

A clinical profile and the course and outcome with therapy of 126 infants and children with gastroesophageal reflux (GER), diagnosed at a median age of 2.5 months and followed for 1.5 to 3.5 years is presented. Features included repeated regurgitation or rumination (99%), signs suggesting esophageal pain (49%, excessive crying "colic," sleep disturbance, Sutcliffe-Sandifer syndrome, respiratory symptoms 42%), failure to thrive (18%), and minor hematemesis (18%). Feeding problems and maternal distress were common, associated with child abuse in four cases. Therapy was initially conservative (posture, thickening of feeds, antacids, bethanechol), augmented by cimetidine in those with proven esophagitis (n = 34, 0.27%). Most (81%) were symptom-free by 18 months of age (55% by 10 months of age); 17 percent had fundoplication with good results; 2 percent have persisting symptoms beyond 2 years of age (1% failed surgery). No deaths were recorded. Surgery was performed for recurrent apneas/aspiration (6%), refractory esophagitis or stricture (5%), and failed medical management (7%). Esophagitis was a significant determinant to outcome, and the importance of selective early endoscopy is emphasized. GER is a cause of considerable morbidity in infants but, with active therapy, is self-limiting in the majority. Certain distinctive clinical signs indicate those patients who require detailed investigation and to whom more aggressive therapeutic efforts should be directed.
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PMID:Gastroesophageal reflux in children. Clinical profile, course and outcome with active therapy in 126 cases. 380 92


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