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

The technique and scoring system of 24-hr pH esophageal monitoring has been modified to evaluate gastroesophageal reflux in infants and children. The data from two pediatric controls and five clinical cases are presented and compared to normal adult values. This test has better objectivity, precision, sensitivity, and reliability than contrast studies, endoscopy, esophageal biopsy, acid perfusion, or acid reflux tests. The 24-hr pH monitoring assists the evaluation of sphincter maturation, pulmonary disease, and the significance of body position. With more experience, this technique could identify children at risk fo developing severe complications of reflux esophagitis and aid in the selection of candidates for surgical intervention.
J Pediatr Surg 1977 Dec
PMID:Technique and experience with 24-hour esophageal pH monitoring in children. 2 95

Intraoperative lower esophageal sphincter (LES) pressures and lenghts were measured in 10 pediatric patients requiring surgery for compications of gastroesophageal reflux. LES pressure changed significantly pre- and post-Nissen fundoplication (9.8 +/- 1.51 mm Hg vs. 32.8 +/- 2.68 mm Hg, p less than 0.001). LES length also showed a significant change (1.3 +/- 0.13 cm vs. 2.8 +/- 0.26 cm, p less than 0.001). One week postoperatively LES pressures were significantly greater than preoperative values (26.4 +/- 1.74 mm Hg vs. 15.6 +/- 2.64 mm Hg, p less than 0.01). Eight of 10 patients have been evaluated 6 mo post fundoplication. None has gastroesophageal reflux by acid reflux testing or water siphon barium esophagram. None of the 10 patients has had gas bloat syndrome during the follow-up period.
J Pediatr Surg 1978 Dec
PMID:Use of intraoperative esophageal manometrics in surgical treatment of gastroesophageal reflux in pediatric patients. 3 35

Thirty-four patients with sliding hiatal hernia, gastroesophageal reflux, or both were treated by lesser curvature gastroplasty with partial gastric plication, using a surgical stapler. Before operation, esophageal manometric studies were performed in 33 patients and during the early postoperative period (1 to 3 months), in 34. The esophageal pH test was performed before operation in 22 patients, shortly after discharge in 27, and later in 30 patients. The clinical results were considered satisfactory in 30 patients (88%) after follow-up ranging from 18 to 33 months (average, 23 months). Before the procedure, the abdominal compression test was positive in 25 of 30 patients (83%). In early postoperative studies it was positive in 1 out of 34 patients (3%), but in the second series of postoperative studies it was positive in 9 out of 32 (28%). After instillation of hydrochloric acid into the stomach, the esophageal pH test was considered positive in 17 out of 22 patients in preoperative studies (77%). In early postoperative studies the test was positive in 3 out of 27 patients (11%) and one year later, in 7 out of 30 (23%). The later postoperative studies showed a higher number of positive reflux tests than the early studies, 28 and 23% positive in manometric and pH tests, respectively.
Ann Thorac Surg 1978 Dec
PMID:Lesser curvature tubular gastroplasty with partial plication for gastroesophageal reflux: manometric and pH-metric postoperative studies. 3 10

Symptomatic infants displayed three patterns of gastroesophageal reflux after drinking apple juice (20 ml/kg or 300 ml/m2 of body surface area). The type I pattern occurred in patients who had continuous postcibal gastroesophageal reflux, large hiatal hernias and frequently required an antireflux operation. A functional motility disorder suggesting delayed gastric emptying appeared to be important in infants with discontinuous reflux (type II pattern). These infants had frequent gastroesophageal reflux for only 2 3/4 hours postcibally, antral-pylorospasm, increased low esophageal sphincter pressures, and a high incidence of pulmonary symptoms and non-specific watery diarrhea. The mixed (type III) pattern of gastroesophageal reflux occurred in a small number of infants and exhibited features of both type I and II patterns.
Am J Surg 1979 Dec
PMID:Patterns of postcibal gastroesophageal reflux in symptomatic infants. 4 57

6 cases of cardiorespiratory complications occurring after surgical treatment of oesophageal atresia are reported by virtue of the association of tracheal compression by the brachio-cephalic arterial trunk and of gastro-oesophageal reflux. In all cases, medical (2 cases) or surgical (4 cases) treatment of gastro-oesophageal reflux led to the disappearance of all respiratory symptoms and signs. Emphasis is placed upon the need for a routine and thorough search, radiological and endoscopic, of such associated oesophageal pathology, before proceeding to surgery on the compressive brachio-cephalic arterial trunk.
Ann Otolaryngol Chir Cervicofac 1979 Dec
PMID:[Compressive brachio-cephalic arterial trunk and gastro-oesophageal reflux following surgery for oesophageal atresia (author's transl)]. 39 46

Gastroesophageal reflux has been suggested to play a causal role in a variety of chronic pulmonary disorders. This hypothesis has been supported by the increased incidence of reflux in patients with idiopathic pulmonary disorders and by the anecdotal reports of symptomatic improvement following surgical correction of the reflux. In an effort to determine whether patients with reflux as a group demonstrated a significant degree of pulmonary dysfunction, 100 patients with reflux were compared with another group of 100 control patients, matched for age and sex and without demonstrable reflux. Standard pulmonary function studies were used for this comparison. No difference could be detected between the two groups, which suggested that the isolated findings of reflux in patients with pulmonary disorders should not be considered etiologic by virtue of the association alone. Alternate explanations for the relationship are given.
Chest 1979 Dec
PMID:Pulmonary functional in patients with gastroesophageal reflux. 51 6

Eight cases of symptomatic hiatal hernia were investigated; four presented with respiratory symptoms simulating chronic asthmatic bronchitis or bronchopneumonia. Among 27 patients with gastro-oesophageal reflux but without radiologically visible hernia, six presented with fibrous stricture; no stricture was found in association with hiatal hernia. It is suggested that patients with gastro-oesophageal reflux should be offered surgical follow-up or surgery to prevent the development of a stricture before the more easily recognizable symptoms of heart burn and postural acid regurgitation get worse.
Trop Geogr Med 1979 Dec
PMID:Hiatal hernia in the African. 54 91

Gastrin has a regulating effect on the complicated closing mechanism of the lower oesophageal sphincter. This hormone produced in G-cells of the pyloric antrum and carried by the blood stream has its greatest effect on the anterior fundus wall, cardias and the lower oesophageal sphincter. Thus, when there is a failure in the closing mechanism of the lower oesophageal sphincter produced by lacking maturity of the oesophageal fibers and the cardias zone, only those surgical procedures using the gastric fundus in order to correct the failure can guarantee a good result, if medical treatment has not been successful. The authors comment on the physiological basis of the treatment, the medical as well as the surgical one, of the gastro-oesophageal reflux.
An Esp Pediatr 1978 Dec
PMID:[Gastroesophageal reflux in infancy. The physiological basis of management (author's transl)]. 57 Mar 67

The association between lower esophageal sphincter (LES) incompetence, gastroesophageal reflux, and recurrent pneumonia in patients who have undergone successful repair of esophageal atresia (EA) and tracheoesophageal fistula is demonstrated in this study. The efficacy of esophageal manometric examination in the evaluation of the LES in young children after EA repair is documented. This study also provides evidence that infants and children with LES incompetence associated with EA may have LES responsiveness to bethanechol. Once established by manometry, this responsiveness may be used to manage the patient until surgical repair would be advantageous.
J Pediatr Surg 1977 Dec
PMID:Lower esophageal sphincter dysfunction in esophageal atresia: nocturnal regurgitation and aspiration pneumonia. 59 67

Our experience for the past four years with antireflux surgery has been reviewed. The Nissen fundoplication resulted in symptomatic improvement in 87.5 per cent of cases as compared with 64 per cent who were improved after the Belsey Mark IV procedure. Objective evaluation as measured by the standard acid reflux test (SART) revealed recurrent reflux in 9 per cent of those who underwent fundoplication and in 47 per cent of those treated with the Belsey repair. Mortality rates were similar. These results indicate that Nissen fundoplication is superior to the Belsey Mark IV procedure in the management of gastroesophageal reflux.
Am J Surg 1977 Dec
PMID:Comparison of Nissen fundoplication and Belsey Mark IV in the management of gastroesophageal reflux. 59 36


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