Gastro-oesophageal reflux and oesophageal dysfunction in children and adolescents with brain damage.
The prevalence of pathological gastro-oesophageal reflux (GOR) and oesophageal dysfunction (OD) was investigated in 32 children, 0.7-19 years of age (mean 11.2 years), with brain damage, mainly severe cerebral palsy and tetraplegia. They underwent 24-h pH monitoring in the distal oesophagus and oesophageal manometry. In addition, radiological examination of the oesophagus, chest radiography, blood counts and blood tests for iron deficiency were carried out. Fifteen (47%) patients had mild pathological acid reflux, 5 (16%) had moderately severe and 5 (16%) severe acid GOR. Seven of 32 (22%) patients had no pathological GOR. Ten patients had abnormal manometry findings and 9 had a pathological radiological oesophagus examination. Three patients had radiographic lung consolidations. Thirteen patients had iron deficiency and 5 were anaemic. Two patients with severe acid reflux have died, presumably from aspiration-induced pneumonia. Findings of OD and GOR are frequent in children with brain damage and are related to significant complications, including fatal course.
Department of Paediatrics, Faculty of Health Sciences, University Hospital, Linköping, Sweden.
P M
PM
Gustafsson
L
L
Tibbling
D000293:Adolescent; D000328:Adult; D001930:Brain Injuries / Q000150:complications* / Q000503:physiopathology; D002547:Cerebral Palsy / Q000150:complications / Q000503:physiopathology; D002648:Child; D002675:Child, Preschool; D004935:Esophageal Diseases / Q000209:etiology* / Q000503:physiopathology; D005260:Female; D005764:Gastroesophageal Reflux / Q000209:etiology* / Q000503:physiopathology; D006801:Humans; D007223:Infant; D008297:Male; D018670:Monitoring, Ambulatory; D011782:Quadriplegia / Q000150:complications / Q000503:physiopathology