title: Esophageal Bolus Transit in Newborns with Gastroesophageal Reflux Disease Symptoms: A Multichannel Intraluminal Impedance Study.
abstract: OBJECTIVE
  The aim of this study was to evaluate bolus transit during esophageal swallow (ES) and gastroesophageal reflux (GER) events and to investigate the relationship between the characteristics of ES and GER events in a population of term and preterm newborns with symptoms of gastroesophageal reflux disease (GERD).
  
  
  METHODS
  The study population consisted of term and preterm newborns referred to combined multichannel intraluminal impedance (MII) and pH monitoring for GERD symptoms. The frequency and characteristics of ES and GER events were assessed by two independent investigators. Statistical significance was set at p<0.05.
  
  
  RESULTS
  Fifty-four newborns (23 preterm) were included in the analyses. Median bolus head advancing time corrected for esophageal length (BHATc) was shorter during mealtime than during the postprandial period (median, interquartile range): 0.20 (0.15-0.29) s/cm vs. 0.47 (0.39-0.64) s/cm, p<0.001. Median bolus presence time (BPT) was prolonged during mealtime: 4.71(3.49-6.27) s vs. 2.66 (1.82-3.73) s, p<0.001. Higher BHATc (p=0.03) and prolonged BPT (p<0.001) were observed in preterm newborns during the postprandial period. A significant positive correlation between BHATc and bolus clearance time was also observed (ρ=0.33, p=0.016).
  
  
  CONCLUSIONS
  The analysis of ES and GER events at the same time by MII provides useful information to better understand the physiopathology of GERD. In particular, the analysis of BHATc during the postprandial period could help clinicians identify newborns with prolonged esophageal clearance time due to impaired esophageal motility, which could allow for more accurate recommendations regarding further tests and treatment.
authors.affiliation: Neonatal Intensive Care Unit, S.Anna-Regina Margherita Children's Hospital, Torino, Italy.; Department of Pediatrics, University of Torino, Torino, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Cresi
authors.affiliation: Neonatal Intensive Care Unit, Maria Vittoria Hospital, Torino, Italy.
authors.forename: Stefania Alfonsina
authors.initials: SA
authors.lastname: Liguori
authors.affiliation: Neonatal Intensive Care Unit, S.Anna-Regina Margherita Children's Hospital, Torino, Italy.; Department of Pediatrics, University of Torino, Torino, Italy.
authors.forename: Elena
authors.initials: E
authors.lastname: Maggiora
authors.affiliation: Neonatal Intensive Care Unit, S.Anna-Regina Margherita Children's Hospital, Torino, Italy.; Department of Pediatrics, University of Torino, Torino, Italy.
authors.forename: Emanuela
authors.initials: E
authors.lastname: Locatelli
authors.affiliation: Department of Pediatrics, University of Bari Policlinico, Bari, Italy.
authors.forename: Flavia
authors.initials: F
authors.lastname: Indrio
authors.affiliation: Neonatal Intensive Care Unit, S.Anna-Regina Margherita Children's Hospital, Torino, Italy.; Department of Pediatrics, University of Torino, Torino, Italy.
authors.forename: Enrico
authors.initials: E
authors.lastname: Bertino
authors.affiliation: Neonatal Intensive Care Unit, S.Anna-Regina Margherita Children's Hospital, Torino, Italy.; Department of Pediatrics, University of Torino, Torino, Italy.
authors.forename: Alessandra
authors.initials: A
authors.lastname: Coscia
keywords: Esophageal impedance; Esophageal swallow; Gastroesophageal reflux; Newborn; Premature birth