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Type: Journal article
Title: Esophageal body and lower esophageal sphincter function in healthy premature infants
Author: Omari, T.
Miki, K.
Fraser, R.
Davidson, G.
Haslam, R.
Goldsworthy, W.
Bakewell, M.
Kawahara, H.
Dent, J.
Citation: Gastroenterology, 1995; 109(6):1757-1764
Publisher: Elsevier North Holland
Issue Date: 1995
ISSN: 0016-5085
Statement of
Omari, Taher I.; Miki, Kazunori; Fraser, Robert; Davidson, Geoff; Haslam, Ross; Goldsworthy, Wendy; Bakewell, Malcolm; Kawahara, Hisayoshi; Dent, John
Abstract: <h4>Background & aims</h4>Gastroesophageal reflux is a common problem in premature infants. The aim of this study was to use a novel manometric technique to measure esophageal body and lower esophageal sphincter pressures in premature infants.<h4>Methods</h4>Micromanometric feeding assemblies (OD, < or = 2 mm) incorporating 4-9 manometric channels were used in 49 studies of 27 premature neonates. Esophageal body motility was recorded at three sites for 20 minutes after feeding. Twenty attempts (one per minute) were made to stimulate swallowing via facial stimulation (Santmyer reflex). In 32 studies lower esophageal sphincter pressures were recorded (sleeve) for 15 minutes before and after feeding.<h4>Results</h4>Peristaltic motor patterns were less common than non-peristaltic motor patterns (26.6% vs. 73.4%; P < 0.0001) that comprised 31.1% synchronous, 34.6% incomplete, and 6.3% retrograde pressure waves. Reflex swallowing was elicited more frequently in neonates older than 34 weeks postconceptional age than in younger infants (33.4% vs. 20.4%; P < 0.05). Mean lower esophageal sphincter pressure was 20.5 +/- 1.7 mm Hg before and 13.7 +/- 1.3 mm Hg after feeding (P < 0.0005).<h4>Conclusions</h4>Premature infants show nonperistaltic esophageal motility that may contribute to poor clearance of refluxed material. In contrast, the lower esophageal sphincter mechanisms seem well developed.
Keywords: Esophagus
Esophagogastric Junction
Regression Analysis
Physical Stimulation
Gastrointestinal Motility
Infant, Newborn
Infant, Premature
Rights: GER; gastroesophageal reflux; PCA; postconceptual age; PNA; postnatal age
DOI: 10.1016/0016-5085(95)90741-6
Appears in Collections:Aurora harvest
Paediatrics publications

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