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714 Relationship Between Esophageal Swallow Patterns and Reflux Characteristics in Newborns with Symptoms of Gastroesophageal Reflux Disease
  1. F Cresi1,
  2. SA Liguori1,
  3. E Locatelli1,
  4. E Maggiora1,
  5. F Savino2,
  6. E Bertino1
  1. 1Neonatal Intensive Care Unit, Department of Paediatrics
  2. 2Dep. of Pediatrics, University of Torino, Torino, Italy

Abstract

Background and Aims Transient lower esophageal sphincter relaxations are primarily responsible for GER in healthy infants and plays an important role in preterm and term infants with GER disease (GERD). Gastroesophageal dismotility due to immaturity could also promote impaired swallowing patterns influencing the esophageal clearance. The aim of this study was to investigate the relationship between esophageal swallow patterns and reflux characteristics in newborns with GERD symptoms.

Methods Esophageal swallow patterns and refluxes were visually evaluated in preterm and at term bottle fed newborns who underwent Multichannel Intraluminal Impedance (MII) analysis for clinical suspect of GERD.

The swallow frequency, the mean Bolus Head Advance Time (BHAT), the mean Total Bolus Transit Time (TBTT) and reflux characteristics (frequency, duration and impedance bolus exposure index) were assessed for each patient.

Pearson correlation was used to evaluate the relationship between swallow and reflux variables; p was set at 0.05.

Results Fifty-four newborns (10 preterm) were enrolled in the study. They had a median(IQR) age of 22(22.5) days, a Gestational age of 37(6) weeks and a postconceptional age of 41.8(4.9) weeks. A significant positive correlation was found between TBTT and IBEI% (r=0.494; p<0.001) and between TBTT and reflux duration (r=0.321; p=0.018).

Conclusions MII is a valid technique to evaluate esophageal bolus transit and refluxes. Our data support that esophageal motor dysfunction due to immaturity affect esophageal swallowing patterns and esophageal clearance time in GERD newborns.

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