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Type: Journal article
Title: Mechanisms of gastroesophageal reflux in healthy premature infants
Author: Omari, T.
Barnett, C.
Snel, A.
Goldsworthy, W.
Haslam, R.
Davidson, G.
Kirubakaron, C.
Bakewell, M.
Fraser, R.
Dent, J.
Citation: Journal of Pediatrics, 1998; 133(5):650-654
Issue Date: 1998
ISSN: 0022-3476
Statement of
Taher I. Omari, Christopher Barnett, Antonie Snel, Wendy Goldsworthy, Ross Haslam, Geoff Davidson, Chellam Kirubakaran, Malcolm Bakewell, Robert Fraser and John Dent
Abstract: <h4>Objectives</h4>The aim of this study was to characterize the motor events responsible for gastroesophageal reflux (GER) and esophageal acid clearance in a cohort of healthy preterm infants.<h4>Study design</h4>Esophageal motility was recorded for 2 to 3 hours after a feeding in 24 preterm infants, 31 to 38 weeks' postmenstrual age, by using a sleeveside hole micromanometric assembly incorporating a pH probe.<h4>Results</h4>Sixty acid GER episodes were recorded by pH probe, and 133 non-acid GER episodes were recorded manometrically by the presence of esophageal common cavities. Of the 193 GER episodes, 159 (82%) were associated with transient lower esophageal sphincter relaxation (TLESR). TLESRs were significantly longer in duration than single swallows (15.1 seconds vs 5.6 seconds, P < .001) and had lower nadir pressures (0.8 mm Hg vs 2.3 mm Hg, P < .001). A total of 3216 esophageal body pressure waves were analyzed; 70% of swallow-induced pressure waves were peristaltic in sequence compared with 5% of swallow-unrelated pressure waves. During periods of esophageal acidification (pH below 4), peristaltic esophageal body pressure wave sequences cleared acid refluxate more effectively than nonperistaltic pressure wave sequences.<h4>Conclusions</h4>In healthy preterm infants, TLESRs are the predominant mechanism underlying GER, and esophageal clearance mechanisms are well developed by at least 31 weeks' postmenstrual age.
Keywords: Esophagus
Esophagogastric Junction
Gastric Acid
Gastroesophageal Reflux
Infant, Premature, Diseases
Gastric Acidity Determination
Cohort Studies
Infant, Newborn
DOI: 10.1016/S0022-3476(98)70106-4
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Paediatrics publications

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