scholarly journals Gastroesophageal reflux disease in pediatric esophageal atresia: Assessment of clinical symptoms and pH-impedance data

2020 ◽  
Vol 9 (2) ◽  
pp. 29-43
Author(s):  
Marina Aksionchyk ◽  
Kirill Marakhouski ◽  
Aliaksandr Svirsky
Keyword(s):  
Gastroesophageal Reflux Disease ◽  
Gastroesophageal Reflux ◽  
Esophageal Atresia ◽  
Reflux Disease ◽  
Clinical Symptoms ◽  
Impedance Data

scholarly journals Features of the course and comparative characteristics of gastroesophageal reflux disease in pediatric patients with esophageal atresia after primary repair

2020 ◽  
pp. 24-29
Author(s):  
M.G. Aksionchyk ◽  
◽  
K.Y. Marakhousk ◽  
V.I. Averin ◽  
◽  
...  
Keyword(s):  
Gastroesophageal Reflux Disease ◽  
Gastroesophageal Reflux ◽  
Esophageal Atresia ◽  
Reflux Disease ◽  
Pediatric Patients ◽  
Impedance Measurement ◽  
Index Number ◽  
Common Symptom ◽  
Esophageal Mucosa ◽  
Significant Difference

The aim is to evaluate clinical data and data of intraesophageal 24-hour pH/impedance measurement in pediatric patients with corrected esophageal atresia. Material and methods. A retrospective analysis was carried out on the basis of inpatient records of 43 pediatric patients with corrected esophageal atresia (CEA) aged from 1 to 14 years, who were examined at the State Institution «Republican Scientific and Practical Center of Pediatric Surgery» from November 2017 to March 2020. Average age of the group: 5.09±1.2 years, of which 23 boys (53.5%), 20 girls (46.5%). All patients with CEA underwent esophagogastroduodenoscopy (EGD) and intraesophageal 24-hour pH/impedance measurement while off acid-suppressive therapy. Results. Depending on the results of pH/impedance measurement, the patients with CEA were divided into two groups: CEA with gastroesophageal reflux disease (GERD) – 20 (54.1%) and CEA without GERD – 17 (45.9%). The most common symptom in patients with CEA was cough in both groups, in 26 (70.27%) children. Only in 4 out of 37 patients with CEA no symptoms during the time of the study were registered. Upper gastrointestinal tract endoscopy showed that 16 (43.2%) children with CEA had grade A esophagitis (according to the Los Angeles classification), 1 (2.7%) had gastric metaplasia of the esophageal mucosa, and 6 (16.2%) had chronic gastritis. EGD data did not reveal any significant differences between CEA patients with GERD and CEA patients without GERD (P=0.819). When comparing pH/impedance parameters, a significant difference (P<0.005) was obtained for the following parameters: reflux index, number of reflux episodes, distal mean nocturnal baseline impedance (MNBI) and duration of the longest reflux episode. In addition, the positive association of symptoms with episodes of refluxes (>95%) in the group of CEA patients without GERD was significantly higher than in CEA patients with GERD: 3/20 (15%) versus 8/17 (47.06%). Conclusions. The prevalence of GERD in patients with CEA in this study was 54.06%. Extraesophageal symptoms (in particular, cough) are prevalent in patients with CEA (70.3%). GERD can be asymptomatic in patients with CEA. In this study, 15% of CEA patients with confirmed GERD were asymptomatic. Patients with CEA in the study groups rarely had typical GERD symptoms (heartburn, regurgitation, chest pain and belching). The research was carried out in accordance with the principles of the Declaration of Helsinki. The research protocol was approved by the Local Ethics Committee of the institutions indicated in the article. Informed consent of parents and children was obtained for the research. The authors declare no conflicts of interest. Key words: corrected esophageal atresia, gastroesophageal reflux disease, esophagitis, children, esophageal 24-hour pH/impedance measurement.

scholarly journals Treatment of Non-erosive Effect of Clinical Study of Gastroesophageal Reflux Disease

2018 ◽  
Vol 6 (3) ◽  
Author(s):  
Qian Liu
Keyword(s):  
Treatment Group ◽  
Gastroesophageal Reflux Disease ◽  
Gastroesophageal Reflux ◽  
Reflux Disease ◽  
Clinical Symptoms ◽  
Effective Rate ◽  
Control Group ◽  
Significant Difference ◽  
Before And After ◽  
And Control

<p class="18">Abstract: Objective: To observe the clinical effect of “Chaihu Shugan Powder Zuojin Pill” in the treatment of non-erosive gastroesophageal reflux disease. Methods: Sixty patients with non-erosive gastroesophageal reflux disease were randomly divided into treatment group and control group (30 cases in each group). The patients were treated with “Zaohu Shugan Powder” and “Zangjin Pills” and omeprazole respectively. For 8 weeks, the clinical efficacy and changes in clinical symptoms were observed. Results: The total effective rate was 93.3% in the treatment group and 80.0% in the control group. There was significant difference between the two groups before and after treatment (P &lt;0.05). Conclusion: “Chaihu Shugan Powder Zuojin Pill” can effectively improve the clinical symptoms of non-erosive gastroesophageal reflux disease.</p>

DOZ047.69: Tracking outcomes of tracheoesophageal fistula and esophageal atresia in pediatric population

2019 ◽  
Vol 32 (Supplement_1) ◽  
Author(s):  
I Sharma ◽  
S Thaker ◽  
T Jensen ◽  
C Finck
Keyword(s):  
Gastroesophageal Reflux Disease ◽  
Gastroesophageal Reflux ◽  
Esophageal Atresia ◽  
Reflux Disease ◽  
Tracheoesophageal Fistula ◽  
Surgical Intervention ◽  
Clinical Pathways ◽  
Pediatric Population ◽  
Retrospective Chart Review ◽  
Congenital Deformity

Abstract Purpose The purpose of this study is to conduct a retrospective chart review of patients with a rare congenital deformity, tracheoesophageal fistula, and esophageal atresia treated at a small, freestanding Children's Hospital. The goal is to identify important variables to inform clinical pathways and prospective database creation. Current national surgical quality databases do not track tracheoesophageal fistula/esophageal atresia (TEF/EA)-specific data points such as TEF-type and incidence of postoperative complications such as gastroesophageal reflux disease (GERD) and esophageal stricture. Methods Patients diagnosed with esophageal atresia and trachesophageal fistula between January 2005 and January 2019 were identified using the appropriate ICD 9 or ICD 10 codes. Data for 35 variables including patient demographics and type of esophageal atresia were abstracted. SPSS 16.0 software was used for descriptive statistics. Results A total of 43 patients were identified, 64.3% female and 35.7% male. 77.5% were type C, 12.5% type A, 7.5% type H, and 2.5% type D. 15% were long-gap type. 53.8% had postoperative esophageal strictures, and 66.7% had postoperative gastroesophageal reflux disease. Of those who had strictures, 77.2% of patients required at least three postoperative dilations for stricture, with an overall mean six dilations. 26.2% of patients had tracheomalacia; of these, two patients underwent thoracoscopic aortopexy. Four patients were not included in subgroup analysis: two patients had missing variables, one patient passed away before surgical intervention, and one patient has not yet undergone surgical intervention for EA/TEF. Conclusions We conclude that, although a rare congenital anomaly, a database dedicated to tracheoesophageal fistula and esophageal atresia at a pediatric hospital can aid in reviewing trends in outcomes and inform standardization of management.

The effectiveness of the osteopathic correction in the complex treatment of adult patients with gastroesophageal reflux disease

2021 ◽  
pp. 69-79
Author(s):  
T. P. Naletova ◽  
E. P. Udintsev ◽  
A. Yu. Oreshko ◽  
O. A. Chusovitina
Keyword(s):  
Gastroesophageal Reflux Disease ◽  
Gastroesophageal Reflux ◽  
Reflux Disease ◽  
Clinical Symptoms ◽  
Life Quality ◽  
Adult Patients ◽  
Control Group ◽  
Complex Treatment ◽  
Number Of Patients ◽  
Therapy Effectiveness

Introduction. Gastroesophageal reflux disease (GERD) is now widespread throughout the world, with clear evidence of incidence increase in many countries. The importance of GERD is caused by the fact that it leads to a significant decrease in the patient′s life quality, the appearance of extraesophageal symptoms (chest pain, persistent cough) and the risk of such complications as bleeding from ulcers and erosions, the development of peptic strictures, and esophageal adenocarcinoma. After stopping the medicine treatment, the relapse quickly occurs and it is the main risk factor for the development of Barrett′s esophagus — a precancerous pathology of the esophagus. Therefore, the search for additional, non-drug methods of treatment for increasing the standard therapy effectiveness is in demand. Osteopathic correction of somatic dysfunction can be one of these methods. To date, there is some evidence of the osteopathic correction effectiveness in children with GERD.The goal of research — to study the effectiveness of osteopathic correction in the complex treatment of adult patients with GERD.Materials and methods. The study involved 20 people, divided by simple randomization into two equal groups: control and main. The control group received standard treatment, the main group received additional osteopathic correction. At the beginning and at the end of the study, there were assessed the osteopathic status of patients and the severity of the disease using the GerdQ questionnaire. The obtained data were processed by methods of nonparametric statistics.Results. The inclusion of osteopathic correction in the complex treatment of patients with GERD is accompanied by a statistically significant decrease in the number of local and regional somatic dysfunctions (SD), a significant redistribution of the dominant SD structure, and a decrease in the severity of previously dominant SD in the neck and thoracic region. Compared with patients who did not receive osteopathic correction, there is a statistically significantly more pronounced decrease in the severity of GERD clinical symptoms.Conclusion. Despite the relatively small number of patients who participated in the study, the obtained results make it possible to recommend the inclusion of osteopathic correction in the complex therapy of patients with GERD.

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