ArticleThe Journal of pediatrics2019
Mechanisms of Aerodigestive Symptoms in Infants with Varying Acid Reflux Index Determined by Esophageal Manometry.
Article in The Journal of pediatrics, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
16 citing papers in PubMed.
- Proton pump inhibitor therapy may alter the sensory motor characteristics of pharyngoesophageal motility in infants with suspected GERD.Neurogastroenterology and motility · 2024Trial
- Brief Resolved Unexplained Events Symptoms Frequently Result in Inappropriate Gastrointestinal Diagnoses and Treatment.The Journal of pediatrics · 2024Article
- Characteristics of esophageal refluxate and symptoms in infants compared between pre-treatment and on treatment with proton pump inhibitors.Journal of perinatology : official journal of the California Perinatal Association · 2024Article
- The Irritable Infant in the Neonatal Intensive Care Unit: Risk Factors and Biomarkers of Gastroesophageal Reflux Disease.The Journal of pediatrics · 2024Article
- High-resolution esophageal manometry in children.Clinical and experimental pediatrics · 2023Article
- Pharyngeal biorhythms during oral milk challenge in high-risk infants: Do they predict chronic tube feeding?Neurogastroenterology and motility · 2023Article
- Significant Temporal Association of Esophageal Air Events (Supragastric Belches, Air Swallows, and Gastric Belches) With Hiccups: A Case Study in an Adolescent.JPGN reports · 2022Article
- Article
- Symptom Scores and pH-Impedance: Secondary Analysis of a Randomized Controlled Trial in Infants Treated for Gastroesophageal Reflux.Gastro hep advances · 2022Article
- Feeding Problems and Long-Term Outcomes in Preterm Infants-A Systematic Approach to Evaluation and Management.Children (Basel, Switzerland) · 2021Review
- Mechanisms and management considerations of parent-chosen feeding approaches to infants with swallowing difficulties: an observational study.Scientific reports · 2021Observational
- Diagnostic utility of impedance-pH monitoring in infants of diabetic mothers with oral feeding difficulties.Journal of perinatology : official journal of the California Perinatal Association · 2021Article
- Pharyngoesophageal motility reflex mechanisms in the human neonate: importance of integrative cross-systems physiology.American journal of physiology. Gastrointestinal and liver physiology · 2021Review
- Differentiating esophageal sensitivity phenotypes using pH-impedance in intensive care unit infants referred for gastroesophageal reflux symptoms.Pediatric research · 2021Article
- Mechanisms of bradycardia in premature infants: Aerodigestive-cardiac regulatory-rhythm interactions.Physiological reports · 2020Article
- The enigma of gastroesophageal reflux disease among convalescing infants in the NICU: It is time to rethink.International journal of pediatrics & adolescent medicine · 2020Article
Corrections and comments
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Authors and funding
4 authors.
Funding
Abstract
objectiveTo test whether symptom generation in infants is related to the severity of gastroesophageal reflux disease (GERD) symptoms as determined by the Acid Reflux Index (ARI), stimulus media, and stimulus volume during provocative esophageal manometry. STUDY
designSymptomatic neonates (n = 74) born at a median of 28.9 weeks gestation (range, 23.4-39.4 weeks) were studied at a median of 41.0 weeks (range, 34.6-48.0 weeks) postmenstrual age using 24-hour pH-impedance methods to determine ARI severity, followed by provocative esophageal manometry with graded mid-esophageal infusions (0.1-5.0 mL) of air, water, and apple juice. Peristaltic reflexes and symptom characteristics were compared among ARI severity categories using linear mixed models and generalized estimating equations.
resultsThe effects of 2635 separate esophageal stimuli on reflexes and symptoms were analyzed. Peristaltic reflexes occurred in 1880 infusions (71%), and physical, cardiorespiratory, sensory symptoms were seen in 439 infusions (17%). Symptom prevalence did not differ across the ARI severity categories (ARI <3, 18%; ARI 3-7, 17%; ARI >7, 16%; P = 1.0). Symptom and peristaltic responses increased with incremental stimulus volumes (all media, P < .001).
conclusionsSymptoms and peristaltic reflexes are manifestations of the recruitment of several neurosensory and neuromotor pathways evoked by mid-esophageal infusions. ARI severity grade plays no role in symptom generation, indicating that GERD should not be diagnosed and severity should not be assigned based on symptoms alone. An increase in symptom occurrence was noted with increasing stimulus volumes, which provided increased activation of receptors, afferents, and efferents in evoking peristaltic clearance reflexes.
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