Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0017168 (gastroesophageal reflux disease)
 11,783 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

82 children with gastroesophageal reflux, 43 of whom were seriously neurologically impaired, were operated according to Nissen. A retrospective study compares the results, complications and recurrences between children with and children without neurological disability. There were no major differences between the groups; four of the neurologically impaired children and one without impairment had died from unrelated causes. In 62 children, 31 of whom were neurologically impaired, the operation was completely successful, 13 children (six of whom were neurologically impaired) had minor problems, two (both neurologically impaired) had major problems. The conclusion is that serious neurological impairment can not be considered a contraindication to antireflux surgery.
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PMID:[Anti-reflux surgery is possible also in children with multiple disabilities. Good results after Nissen fundoplication in 10-years experience]. 1127 64

Post-pyloric feeding (PF) allows the administration of enteral nutrition beyond the pylorus, either into the duodenum or, ideally, into the jejunum. The main indications of PF are: upper gastrointestinal tract obstructions, pancreatic rest (e.g., acute pancreatitis), gastric dysmotility (e.g., critically ill patients and chronic intestinal pseudo-obstruction) or severe gastroesophageal reflux with risk of aspiration (e.g., neurological disability). Physiological and clinical evidence derives from adults, but can also be pertinent to children. This review will discuss the practical management and potential clinical applications of PF in pediatric patients. Some key studies pertaining to the physiological changes during PF will also be considered because they support the strategy of PF management.
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PMID:Clinical management of post-pyloric enteral feeding in children. 2592 33

Neurological disability is often associated with feeding and gastrointestinal disorders leading to malnutrition and growth failure. Assessment of nutritional status represents the first step in the clinical evaluation of children with neurological disability. The European Society of Gastroenterology, Hepatology, and Nutrition (ESPGHAN) recently issued a consensus statement on gastrointestinal and nutritional management in children with neurological disability. Here we critically review and address implications of this consensus for clinical practice, including assessment and monitoring of nutritional status, definition of nutritional requirements, diagnosis and treatment of gastro-oesophageal reflux disease, and indications for and modalities of nutritional support. There is a strong evidence base supporting the ESPGHAN guidelines; their application is expected to lead to better management of this group of children.
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PMID:Gastrointestinal and nutritional issues in children with neurological disability. 2980 37