Gastroesophageal Reflux and Related Pathology in Adults Who Were Born With Esophageal Atresia: A Long-Term Follow-up Study

Taylor, Andrew; Breen, Kerry J.; Auldist, A. W.; Catto‐Smith, Anthony G.; Clarnette, Tom; Crameri, Joe; Taylor, Russell G.; Nagarajah, Satish; Brady, Jocelyn; Stokes, Keith B.

doi:10.1016/j.cgh.2007.03.012

Cited by 107 publications

(105 citation statements)

References 15 publications

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“…Prevalence of wheeze ranges 26-43% [10,13,14], and that of doctor-diagnosed asthma (DDA) 12-29% [9,10,12,14,15]. This is generally higher than in children (8.8%) [16] and adults (6%) [17].…”

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confidence: 99%

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Repaired oesophageal atresia: respiratory morbidity and pulmonary function in adults

Sistonen¹,

Malmberg²,

Malmström³

et al. 2010

Eur Respir J

117

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Although after oesophageal atresia (OA) repair in infancy, respiratory problems are common, their natural history remains unclear. We assessed morbidity, pulmonary function (PF), and bronchial hyperresponsiveness (BHR) in adults with repaired OA respiratory.588 patients who underwent surgery for OA during 1947-1985 were identified and those 262 who were alive and had their native oesophagus were included. Respiratory symptoms and respiratory symptom-related quality of life (RSRQoL) were assessed by questionnaire and interview, and the patients underwent spirometry, a histamine challenge test, and an exhaled nitric oxide test. For the questionnaires, we added 287 carefully matched general populationderived controls.Among the 101 (58 male) patients, median age 36 yrs (range 22-56 yrs), respiratory morbidity was significantly increased compared to controls. Patients had more respiratory symptoms and infections, as well as asthma and allergies, and more often impaired RSRQoL (p,0.001 for all). PF tests revealed restrictive ventilatory defect in 21 (21%) patients, obstructive ventilatroy defect in 21 (21%) patients, and both in 36 (36%) patients. A total of 41 (41%) had BHR, and in 15 (15%), it was consistent with asthma. The most significant risk factors for restrictive ventilatory defect were thoracotomy-induced rib fusions (OR 3.4, 95% CI 1.3-8.7; p50.01) and oesophageal epithelial metaplasia (OR 3.0, 95% CI 1.0-8.9; p50.05).After repair of OA, respiratory-related morbidity, restrictive ventilatory defect and BHR extended into adulthood. Nearly half the patients had BHR and over half had a restrictive ventilatory defect. Thoracotomy-induced rib fusions and gastro-oesophageal reflux-associated oesophageal epithelial metaplasia were the strongest risk factors for restrictive ventilatory defect.

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confidence: 99%

“…After repair of OA, approximately one-third of these patients suffer respiratory symptoms in adolescence and adulthood [8][9][10][11][12]. Prevalence of wheeze ranges 26-43% [10,13,14], and that of doctor-diagnosed asthma (DDA) 12-29% [9,10,12,14,15].…”

mentioning

confidence: 99%

Repaired oesophageal atresia: respiratory morbidity and pulmonary function in adults

Sistonen¹,

Malmberg²,

Malmström³

et al. 2010

Eur Respir J

117

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“…There are reports on intestinal metaplasia and cancer in the esophagus of patients with GER operated for esophageal atresia in neonatal period [3,[6][7][8]. Two of our patients underwent fundoplication because of intestinal metaplasia of the esophageal mucosa.…”

Section: Discussionmentioning

confidence: 96%

“…GER can appear at any age (even 5 years after surgery) and diagnostic methods should be repeated several times during child's development [3]. Symptoms of GER are found in 27-75% of patients with esophageal atresia [5][6][7]; dysphagia is the most common among the reported symptoms (85%) [7,8]. A third of patients reported difficulty with swallowing of solid foods, but most of them did not use any dietary restrictions [6] In our group, only half of children with GER had any clinical symptoms characteristic for reflux.…”

Section: Discussionmentioning

confidence: 99%

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Long-term complications of congenital esophageal atresia–single institution experience

et al. 2015

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Objective: To evaluate general health condition of children operated for esophageal atresia, including complications from gastrointestinal tract and skeletal defects. Methods:Between 1990 and 2005, 77 patients were operated for esophageal atresia in the Polish Mother's Health Memorial Hospital. The study was based on retrospective analysis of medical case records of all children with esophageal atresia. All living patients (n=51) were invited for follow-up studies.Results: Pathological gastroesophageal reflux was found in 46.7% of children. Scoliosis was diagnosed in 20 patients. Chest deformations were observed in 43.3% children Conclusion:The absence of clinical symptoms does not exclude the presence of gastroesophageal reflux in children operated for esophageal atresia. Children operated for esophageal atresia should be followed up regularly by a multispecialistic medical team.

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Proton pump inhibitors in esophageal atresia: A systematic review and meta‐analysis

Dimitrov,

Aumar,

Duhamel

et al. 2024

J. pediatr. gastroenterol. nutr.

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Gastroesophageal reflux disease (GERD) is frequent and prolonged in esophageal atresia (EA) pediatric patients requiring routine use of proton pump inhibitors (PPIs). However, there are still controversies on the prophylactic use of PPIs and the efficacy of PPIs on GERD and EA complications in this special condition. The aim of the study is to assess the prophylactic use of PPIs in pediatric patients with EA and its complications. We, therefore, performed a systematic review including all reports on the subject from 1980 to 2022. We conducted meta‐analysis of the pooled proportion of PPI—and no PPI groups using random effect model, meta‐regression, and estimate heterogeneity by heterogeneity index I2. Thirty‐eight reports on the topic met the criteria selection, representing a cumulative 6044 patients with EA. Prophylactic PPI prescription during the first year of life does not appear to prevent GERD persistence at follow‐up and is not associated with a significantly reduced rate of antireflux surgical procedures (ARP). PPIs improve peptic esophagitis and induce remission of eosinophilic esophagitis at a rate of 50%. Their effect on other GERD outcomes is uncertain. Evidence suggests that PPIs do not prevent anastomotic stricture, Barrett's esophagus, or respiratory complications. PPI use in EA can improve peptic and eosinophilic esophagitis but is ineffective on the other EA complications. Side effects of PPIs in EA are almost unknown.

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Gastroesophageal Reflux and Related Pathology in Adults Who Were Born With Esophageal Atresia: A Long-Term Follow-up Study

Cited by 107 publications

References 15 publications

Repaired oesophageal atresia: respiratory morbidity and pulmonary function in adults

Repaired oesophageal atresia: respiratory morbidity and pulmonary function in adults

Long-term complications of congenital esophageal atresia–single institution experience

Proton pump inhibitors in esophageal atresia: A systematic review and meta‐analysis

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