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

Congenital laryngeal stridor (CLS) and laryngomalacia are terms used to describe a common disorder characterized by onset, at or soon after birth, of a harsh respiratory sound mostly audible during inspiration. Typically, laryngoscopy reveals flaccid supraglottic structures which tend to prolapse medially toward the glottis during inspiration. Despite reports of this disorder dating back to the mid-19th century, specific etiology and pathogenesis remain nebulous. Analysis of findings in 30 infants indicate that there are often associated manifestations of delayed development in neuromuscular control. Associated findings include gastroesophageal reflux, obstructive and central apnea, hypotonia, failure to thrive, and pneumonitis. A retrospective review of relevant medical literature along with results of laryngeal dissections and analysis of clinical findings in the 30 cases leads to the conclusion that CLS may be a mild form of localized hypotonia rather than an isolated idiopathic type of anatomic abnormality.
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PMID:Congenital laryngeal stridor (laryngomalacia): etiologic factors and associated disorders. 649 35

There are major differences in gastroesophageal reflux between children and adults. Vomiting, failure to thrive, and respiratory symptoms are more common in children as is a spontaneous, complete resolution of symptoms over time. Abnormalities of gastric emptying are noted in both adults and children and may aggravate the reflux. Children have a better response than adults to surgery, both in the early and late postoperative period.
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PMID:Gastroesophageal reflux and gastric emptying. 664 77

To evaluate response to fundoplication, clinical results for 66 consecutive pediatric patients operated on for gastroesophageal reflux were retrospectively reviewed. Indications for operation were gastroesophageal reflux with apnea, repeated emesis, recurrent pneumonia, failure to thrive, stricture, and esophagitis. All patients had preoperative documentation of significant gastroesophageal reflux by either cinefluoroscopic reflux esophagogram or reflux nuclear scan. Fundoplication was effective in 56 (87%) of 64 patients. None of the patients considered to be operative failures had persistent gastroesophageal reflux. Operative failures occurred primarily in patients with gastroesophageal reflux and apnea or recurrent pneumonia. More advanced diagnostic tests, such as pH monitoring, may help to select patients whose symptoms of apnea and recurrent pneumonia are truly due to reflux. Gastroesophageal reflux produces significant morbidity in pediatric patients and is well treated operatively by fundoplication.
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PMID:Management of severe gastroesophageal reflux in children. 671 68

Review of hospital records of 122 infants, aged between 1 and 25 months, admitted to a teaching hospital with the diagnosis of failure to thrive but without an underlying disease apparent at admission, showed that about one-third of them had no diagnosis after evaluation. Thirty-two per cent were thought to have a social or environmental explantation for poor growth, and 31% were given a specific organic or physiological diagnosis. Of the last group, 2 out 3 were diagnosed as having either gastro-oesophageal reflux or non-specific chronic diarrhoea. Vomiting was often associated with organic or structural disease. On average about 40 laboratory tests and x-ray films were performed per infant, but only 0.8% of all tests showed an abnormality which contributed to the diagnosis of the cause of failure to thrive. Our results stress the importance of social and environmental factors as basic causes of failure to thrive, and suggest that admission to hospital and laboratory testing is unlikely to lead to a specific organic diagnose in a child whose failure to thrive is unexplained after careful history taking and a physical examination.
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PMID:Failure to thrive: diagnostic yield of hospitalisation. 680 15

Thirty-four infants with symptoms of gastroesophageal reflux were evaluated by esophageal manometry, pH probe, and gastric emptying studies. Infants with failure to thrive (group A) and recurrent pulmonary disease (group B) had more severe reflux by pH probe (41.6% and 36.3% reflux time postprandially, respectively) than the group of infants without serious sequellae of gastroesophageal reflux (group C), who had 19.0% reflux time postprandially, p less than 0.01. Lower esophageal sphincter pressure did not vary significantly between infants with severe reflux and milder disease. Groups A and B had significantly decreased peristaltic amplitude in the distal body of the esophagus (28.3 +/- 4.8 and 23.2 +/- 5.5 mmHg, respectively) when compared to group C (50.2 +/- 3.2 mm Hg, p less than 0.01); in addition to a significantly increased number of nonperistaltic sequences. Gastric emptying of isotope-labeled cow's milk formula after 1 h was 20.9% and 22.8% in groups A and B, respectively; significantly delayed compared to 40.6% of the meal emptied in group C infants. Gastric retention was significantly correlated with impaired distal esophageal peristaltic amplitude (r = 0.68) and increased postprandial pH documented reflux (r = 0.60). Our results provide evidence for the diffuse nature of the upper gastrointestinal motility disorder present in severe gastroesophageal reflux of infancy.
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PMID:Esophageal and gastric motor abnormalities in gastroesophageal reflux during infancy. 682 85

Surgery for gastroesophageal reflux in infants and children has been shown to be safe and effective, but long-term results of the surgery have not been investigated. Because studies in adults show objective evidence of recurrent reflux five years postoperatively, we recalled 25 children for long-term follow-up of surgery. The preoperative symptoms of vomiting, apnea, pneumonia, and hematemesis were permanently controlled in all patients. Failure to thrive was reversed in all patients except those with multiple malformations. Extended esophageal pH monitoring revealed only one patient with symptomatic recurrent reflux. As a group, the children had significantly less reflux as measured by extended pH monitoring than did controls. Thirty-six percent of patients had mild to moderate symptoms of gas bloat. Thirty-two percent were described as very slow to finish most meals. Twenty-eight percent were unable to burp or vomit. Twenty-five percent choked on some solids. These symptoms did not correlate with the type of operation performed. Long term outcome of antireflux surgery in children is better than in adults.
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PMID:Long-term follow-up of surgery for gastroesophageal reflux in infants and children. 683 83

Esophageal stricture resulting from gastroesophageal reflux is common among children in Ecuador. The sequence of events is vomiting, recurrent pneumonia, failure to thrive and stricture with resulting malnutrition. The diagnosis is confirmed by barium meal and esophagoscopy. The age of the affected population ranges from one month to 12 years. In the past, surgical treatment included esophageal replacement but the most appropriate current treatment is Nissen fundoplication to restore the gastroesophageal sphincter function.
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PMID:Fundoplication as treatment for gastroesophageal reflux in children. 688 92

The purpose of this study was to investigate the rate of gastric emptying of a liquid meal in young children with symptomatic gastroesophageal reflux of varying intensity. Twenty-three infants (mean age 7.0 +/- 1.4 [SEM] months, range 2 to 14 months) were evaluated for reflux by esophageal manometry, a five-hour pH probe study, and barium swallow. The rate of gastric emptying was determined by using a liquid meal of 4 ounces of cow milk formula labeled with 99mTc sulfur colloid. In seven infants with failure to thrive and objective criteria for severe reflux, the mean gastric emptying was 21.3 +/- 6.4% at one hour. In six infants with reflux and recurrent pulmonary disease, the mean gastric emptying was 19.8 +/- 5.4%. Ten infants with mild reflux, adequate weight gain, and no pulmonary symptoms emptied 44.3 +/- 6.0% of formula at one hour, and six normal adults (mean age 28.3 +/- 2 years) emptied 56.2 +/- 6.5% of formula at one hour. These data suggest that infants with severe GER have significantly delayed gastric emptying, that gastric retention may contribute to the FTT and pulmonary symptoms in these infants, and that abnormal motor function of the gastric fundus may be a significant factor in the pathogenesis of gastroesophageal reflux of infancy.
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PMID:Delayed gastric emptying in infants with gastroesophageal reflux. 689 2

During the past 5 years, 26 infants and children with gastroesophageal reflux were operated on. The results have been highly satisfactory and unattended by serious complications or mortality. Barium fluoroscopy was the most reliable diagnostic method. The indications for operation were persistent vomiting with failure to thrive, recurrent aspiration pneumonia, gastrointestinal bleeding and peptic stricture of the esophagus, not relieved by medical treatment. The high incidence of peptic stricture of the esophagus (50 percent) may reflect delay in diagnosis and medical treatment, which is successful in 60 to 87 percent of the infants with gastroesophageal reflux. Surgical treatment consisted of Nissen fundoplication combined with gastrostomy in cases of esophageal stenosis where dilatations were indicated. Complications related to the operation were minimal. In a follow-up period of 9 months to 5 years, all patients had obtained relief of symptoms of reflux and had excellent nutritional status and normal growth.
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PMID:Surgical treatment of gastroesophageal reflux with esophageal stricture in infancy and childhood. 705 89

Gastroesophageal reflux in infants and children is a complex disease. The diagnosis in 14 operative patients was made utilizing a careful history, barium swallow, technetium radionuclide milk scan, and endoscopy with esophageal biopsy. Symptoms were intractable vomiting, failure to thrive, recurrent pneumonia, apnea, asthma and bronchitis, esophagitis, and esophageal stricture. The pernicious aspects of this disease include a potentially significant mortality in children with severe apnea episodes, increased morbidity with esophagitis, and psychosocial disruption for those children that progress to the teenage years with recurrent vomiting, rumination, heartburn and stricture formation. A high incidence of gastroesophageal reflux unresponsive to medical management was noted with esophageal atresia and neurologic disease. The Nissen fundoplication was used in all patients and proved an effective procedure with a low morbidity and recurrence rate.
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PMID:Gastroesophageal reflux in children: an underrated disease. 707 8


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