Gastroesophageal Reflux: Life-Threatening Disease or Laundry Problem?

A severe infantile form of nemaline myopathy has a high mortality rate when untreated because of subsequent malnutrition and respiratory failure. Three infants with this condition demonstrated persistent vomiting, poor weight gain, and recurrent pneumonias. Esophageal manometry demonstrated decreased lower esophageal sphincter pressures and low amplitude peristalsis; 24-hour esophageal pH monitoring revealed significant gastroesophageal reflux. Medical therapy was ineffective in relieving symptoms. After antireflux surgery, vomiting and respiratory symptoms ceased, and there was no longer significant gastroesophageal reflux during pH monitoring. Our experience indicates that in some infants with nemaline myopathy a severe form of gastroesophageal reflux develops that is not responsive to medical therapy. Early surgical intervention may decrease life-threatening complications associated with gastroesophageal reflux in these infants.

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Adverse outcomes associated with gastroesophageal reflux disease are rare following an apparent life-threatening event

Journal of Hospital Medicine ◽

10.1002/jhm.1941 ◽

2012 ◽

Vol 7 (6) ◽

pp. 476-481 ◽

Cited By ~ 10

Author(s):

Gabrielle Zimbric ◽

Joshua L. Bonkowsky ◽

W. Daniel Jackson ◽

Christopher G. Maloney ◽

Rajendu Srivastava

Keyword(s):

Gastroesophageal Reflux Disease ◽

Gastroesophageal Reflux ◽

Reflux Disease ◽

Adverse Outcomes ◽

Life Threatening ◽

Life Threatening Event

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Prevalence of Gastroesophageal Reflux in Infants with Recurrent Brief Apneic Episodes

Canadian Respiratory Journal ◽

10.1155/1999/546420 ◽

1999 ◽

Vol 6 (5) ◽

pp. 401-404 ◽

Cited By ~ 16

Author(s):

Shahid Sheikh ◽

Thomas C Stephen ◽

Barbara Sisson

Keyword(s):

Risk Factor ◽

Gastroesophageal Reflux ◽

Medical Records ◽

Significant Risk ◽

Significant Risk Factor ◽

Acid Reflux ◽

Diagnostic Dilemma ◽

Esophageal Ph ◽

Life Threatening ◽

The Relationship

BACKGROUND: Apnea in an infant can be a diagnostic dilemma for the treating pediatrician. It is suggested that in some infants, gastroesophageal reflux (GER) might be a factor in the pathogenesis of apnea, although its role as a cause of apnea is still controversial.OBJECTIVE: To evaluate the prevalence of GER in infants presenting with recurrent brief apneic periods.PATIENTS AND METHODS: A retrospective review of the medical records of all the infants who underwent prolonged esophageal pH studies for brief apneic episodes (n=105) at the Kosair Children’s Hospital in the six years from January 1992 to December 1997 was performed. Infants presenting with apparent life-threatening episodes were excluded.RESULTS: Of 105 infants, 72 (68.6%) were younger than two months of age and 22 (21%) were born preterm. Fifty of 105 infants (47.6%) had positive esophageal pH studies for acid reflux. Among infants with positive pH studies, only 21 (42%) had associated gastrointestinal or feeding complaints.CONCLUSION: GER is present in a large number of infants presenting with brief apneic episodes. Though the relationship between the two is still not fully established, GER may be a significant risk factor for such apneic episodes in infants.

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A Case of Apparent Life-Threatening Event: Comorbid Gastric Volvulus Associated Gastroesophageal Reflux Disease and Epilepsy in a 4-Month-Old Boy

Case Reports in Pediatrics ◽

10.1155/2016/5717246 ◽

2016 ◽

Vol 2016 ◽

pp. 1-4

Author(s):

Yoshihiko Takano ◽

Masaki Horiike ◽

Ako Tatsumi ◽

Haruko Sakamoto ◽

Hisanori Fujino ◽

...

Keyword(s):

Gastroesophageal Reflux Disease ◽

Gastroesophageal Reflux ◽

Adverse Events ◽

Reflux Disease ◽

Gastric Volvulus ◽

Serious Adverse Events ◽

Life Threatening ◽

Life Threatening Event

Most isolated episodes of apparent life-threatening events (ALTEs) do not lead to the diagnosis of serious conditions, and their prognoses are generally benign. However, recurrent ALTEs are often associated with a risk of future serious adverse events and should be evaluated for appropriate management. Here we present ALTE case in which gastric volvulus associated gastroesophageal reflux disease was detected as an etiology initially, followed by the detection of epilepsy as another etiology. Clinicians should consider possibility of two or more etiologies in a single recurrent ALTE case.

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Diagnosis and Treatment of Gastroesophageal Reflux in Children

Pediatrics in Review ◽

10.1542/pir.5.3.75 ◽

1983 ◽

Vol 5 (3) ◽

pp. 75-79

Author(s):

John J. Herbst

Keyword(s):

Gastroesophageal Reflux ◽

Physical Examination ◽

Diagnosis And Treatment ◽

Therapeutic Modalities ◽

Life Threatening

Gastroesophageal reflux is a common pediatric problem. It is a problem that may mimic many other conditions and the severity varies from inconsequential to life threatening. The challenge to the physician is to recognize the possibility of its occurrence and to proceed with history, physical examination, and testing to the extent that other conditions are excluded, giving consideration to the severity of the problem. The physician may employ many therapeutic modalities including surgery, while taking into consideration the type and severity of the patient's symptoms.

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