Gastro-oesophageal reflux and the lung

Article Abstract:

Gastroesophageal reflux is the backflow of stomach contents into the esophagus, and may be associated with respiratory problems, such as apnea, or cessation of breathing. Healthy infants can develop gastroesophageal reflux with or without respiratory or gastrointestinal symptoms. Because of problems in measuring the hydrogen levels (a method of assessing acidity) in the esophagus of infants over a 24-hour period, it is difficult to define abnormal gastroesophageal reflux and its relation to respiratory symptoms. An association between gastroesophageal reflux and respiratory symptoms can be supported if the symptoms are alleviated after treatment of the reflux. Studies have shown that treatment of gastroesophageal reflux in patients with pneumonia also decreases respiratory symptoms. However, treatment of respiratory symptoms in children with gastroesophageal reflux has had inconsistent effects on reflux. Reflux may result in the aspiration of fluid into the upper airways or activation of the vagal nerve, which causes constriction of the bronchi. However, patients vary in their respiratory response to reflux, and respiratory symptoms may not always occur. In addition, aspiration appears to cause a relatively small percentage of respiratory problems in these patients. Gastroesophageal reflux should be considered in children with recurrent pneumonia, choking problems, or poorly controlled asthma. The evaluation and care of children with respiratory symptoms and suspected gastroesophageal reflux are discussed. However, the precise relationship between gastroesophageal reflux and respiratory symptoms remains unclear. (Consumer Summary produced by Reliance Medical Information, Inc.)

Evaluation, Gastroesophageal reflux in children, Pediatric gastroesophageal reflux, Pediatric respiratory diseases

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Gastro-oesophageal reflux and respiratory function in infants with respiratory symptoms

Article Abstract:

Gastroesophageal reflux (GOR) occurs when the acidic contents of the stomach flow backward into the esophagus. When this happens, some of the acidic fluid may be inhaled (aspirated) into the trachea (windpipe) and lungs, where it can cause tissue damage. When aspiration of acidic stomach contents occurs in people who have lung disease, it can worsen their conditions. Specifically, aspiration related to GOR may be responsible for causing recurrent respiratory symptoms (such as coughing and wheezing) in adults and children with lung disease. Since few studies have examined the relation between GOR and respiratory symptoms in infants, 38 infants with respiratory symptoms of unknown cause were examined. The infant group included 21 boys and 17 girls between the ages of 3 and 15 months. All of the children had coughing and wheezing for six weeks or more, or had recurrent episodes of coughing and wheezing that lasted for one week or more. GOR was determined by monitoring the pH (a measure of acidity) of the esophagus. Twenty-one infants had a higher incidence of GOR than normal. In three of the infants, GOR appeared to be the cause of the respiratory symptoms. However, in the remaining 18 infants, there was no relation between the amount of GOR and the severity of symptoms. These findings indicate that, in some infants, GOR may be responsible for respiratory symptoms, but in most cases, the amount of reflux is not related to the severity of symptoms. (Consumer Summary produced by Reliance Medical Information, Inc.)

Medical examination, Infants, Lung diseases, Gastroesophageal reflux

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Spinal deformity in patients born with oesophageal atresia and tracheo-oesophageal fistula

Article Abstract:

Respiratory and surgical complications and spinal abnormalities are commonly associated with patients born with esophageal atresia or fistula. In these conditions, there is a failure of the esophageal tube to close or develop properly. From August 1986 to April 1987, interviews were conducted with 302 of the 366 survivors out of 538 patients who had been treated for esophageal atresia or fistula between 1948 and 1985, to determine the extent of spinal deformities in this population. The patients ranged in age from 1 to 37 years (the average was 18 years) and 59 percent were males. Spinal deformity was present in 58 out of 302 patients (19 percent); further analysis showed that spinal deformities occurred in 24 of 51 persons (about 47 percent) with known vertebral anomalies and 34 of the remaining 251 persons with normal vertebrae (14 percent). The predominant spinal deformity was scoliosis, or curvature of the spine (21 of 24), and two thirds of these patients have had or most likely will require corrective surgery. It is recommended that routine screening for spinal birth defects followed by careful observation be a common procedure because it is much easier and better to avoid an increase in the deformity rather than correct a severe one. (Consumer Summary produced by Reliance Medical Information, Inc.)

Abnormalities, Physiological aspects, Esophagus, Esophageal atresia, Spine, Fistula, Tracheoesophageal, Tracheoesophageal fistula

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