title: Esophageal dysmotility elicited by acid perfusion in children with esophagitis.
abstract: OBJECTIVE
  To determine the importance of acid reflux-induced dysmotility in the genesis of noncardiac chest pain in children.
  
  
  METHODS
  We performed esophageal manometries during intraesophageal perfusion with 0.9% NaCl or 0.1 N HCl in 19 children (age, 14.5 +/- 0.5 yr) with gastroesophageal reflux, biopsy-proven esophagitis, and complaints of at least one episode of chest pain per day.
  
  
  RESULTS
  Baseline esophageal motilities were normal in all patients. Eight of 19 children (42%) complained of chest pain during intraesophageal acid perfusion. In three of these eight patients, complaints of chest pain during acid perfusion were temporally associated with "conversion" of previously normal motility patterns to manometric tracings, indicating esophageal dysmotility. Compared with findings during saline perfusion, esophageal acid exposure in these three children resulted in significant increases in both the duration (13.6 +/- 4.0 vs 3.2 +/- 0.2 s, p < 0.05) and amplitude (105.2 +/- 7.8 vs 61.2 +/- 2.1 mm Hg, p < 0.05) of esophageal contractions during wet swallows. Symptoms of chest pain resolved in all patients after therapy with H2-receptor antagonists.
  
  
  CONCLUSIONS
  These data represent the first demonstration of acid-induced esophageal dysmotility in children with chest pain and suggest that reflux-induced motor abnormalities contribute to the onset and/or exacerbation of chest pain in pediatric patients with gastroesophageal reflux and esophagitis.
authors.affiliation: Department of Pediatrics, New York Medical College, Valhalla, USA.
authors.forename: J V
authors.initials: JV
authors.lastname: Ganatra
authors.forename: M S
authors.initials: MS
authors.lastname: Medow
authors.forename: S
authors.initials: S
authors.lastname: Berezin
authors.forename: L J
authors.initials: LJ
authors.lastname: Newman
authors.forename: M
authors.initials: M
authors.lastname: Glassman
authors.forename: H E
authors.initials: HE
authors.lastname: Bostwick
authors.forename: M
authors.initials: M
authors.lastname: Halata
authors.forename: S M
authors.initials: SM
authors.lastname: Schwarz
mesh_terms: D000293:Adolescent; D002648:Child; D015154:Esophageal Motility Disorders / Q000503:physiopathology; D004941:Esophagitis / Q000503:physiopathology*; D004947:Esophagus / Q000503:physiopathology*; D005260:Female; D005764:Gastroesophageal Reflux / Q000503:physiopathology; D006801:Humans; D006851:Hydrochloric Acid; D008297:Male; D008365:Manometry; D010528:Peristalsis; D012965:Sodium Chloride
chemical_list: D012965:Sodium Chloride; D006851:Hydrochloric Acid