Adequate timing of diagnostic tests for gastroesophageal reflux in children with esophageal atresia

Abstract

Objective. Recent guidelines made recommendations for the management of gastroesophageal reflux in patients with esophageal atresia (EA). However, the timing for some diagnostic tests remained somehow unclear. This investigation studied the tests for gastroesophageal reflux in children aged one year old and children aged two or three.Material and methods. Patients with EA who underwent Multichannel Intraluminal Impedance-pH monitoring (MII-pH) and endoscopy-histology were studied retrospectively. Patients aged one when the test was performed were the YO group and patients aged two or three years old formed the OL group. Substantially impaired MII-pH was defined as total number of reflux episodes >105 or >85 (depending on age), or reflux index >10%. Substantially impaired endoscopy was defined as erosive esophagitis or Barrett's esophagus. Substantially impaired histology was defined as moderate-severe esophagitis or Barrett's esophagus. Conventional parameters and substantially impaired values of the tests were compared.Results. Twenty-four patients were studied. Twenty-three MII-pH were performed (12 in YO and 11 in OL): percentages of abnormal conventional parameters of MII-pH were not significantly different in both groups. Twenty endoscopies with biopsies were performed (7 in YO and 13 in OL): percentages of esophagitis were not significantly different. Interestingly, 26.9% of all the tests performed in YO were substantially impaired vs. 10.8% of all the tests in OL (χ 2 = 2.7; p = 0.1). Conclusion.Considering the percentage of alarming results of diagnostic tests in the YO group it would be advisable that patients with EA undergo MII-pH and endoscopy-histology at one year of age.

Biocompatible and Biomimetic Minerals Serum Can Reverse Dental Erosion and Improve Tooth Shade Variation.

“…The burden of this problem is significant especially considering the fact that tooth demineralization happens several times a day after eating, drinking or when pathological habits occur e.g. gastroesophageal reflux, chronic gastritis, hiatal hernia, esophageal atresia, bulimia and more [2][3][4]. The modern society often experimented erosive tooth wear, since it has been described as the second most prevalent oral disease after dental caries [5].…”