Abstract
Background: Gastroesophageal reflux (GER) is a common and relevant clinical problem in infants. Relationships between GER and gastric emptying are still unclear. The multiple intraluminal impedance (MII) technique is based on the intraluminal measurement of electrical impedance between 6 electrodes during a bolus passage. On the basis of the temporal sequence of impedance changes, it can be identified whether a change in impedance is caused by a bolus moving in an antegrade (swallow) or a retrograde (reflux) direction. Epigastric impedance (EGI) is a technique to evaluate gastric emptying by measuring modifications in the impedance value in the gastric area by means of 4 skin electrodes. Aim of this study was to investigate the relationship between GER and gastric emptying by multiple intraluminal impedance and epigastric impedance in infants.
Methods: 9 term infants with GER simptoms were evaluated by MII (Sleuth Recorder Sandhill) connected to an intraluminal 6 channel probe and by EGI (Akern) simultaneously. Data were collected for 180 min after the ingestion of a milk meal for two time for each patient. Refluxate events were detected by MII as impedance changes in the distal channels proceeded sequentially to the more proximal channels. From the epigastric impedance emptying curve was calculated for each refluxate event the level of gastric emptying and the emptying velocity (figure). Data were compared by using Pearson correlation.
Results: 18 simultaneously analysis were performed for a total of 54 hours recording. 163 refluxate events were detected. The average emptying time and the number of reflux events were respectively 132±34(minutes), 9.1±3.3(events/ analysis). The frequency of refluxate events was significantly correlated with the emptying velocity (r=0.93; p<0.05). No correlations were found between GER and gastric emptying time or level of gastric emptying.
Conclusion: Gastric emptying in GER infants has not a linear trend. Delayed emptying periods with an increasing of refluxate events are followed by fast emptying periods with decreasing of refluxate events. This variability suggests that a dismotility disorder interesting all the gastroesophageal tract might be relevant in infants affected by GER.
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Cresi, F., Savino, F., Vinciguerra, T. et al. 55 Relationship Between Gastroesophageal Reflux and Gastric Emptying in Infants. Pediatr Res 56, 473 (2004). https://doi.org/10.1203/00006450-200409000-00078
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DOI: https://doi.org/10.1203/00006450-200409000-00078