Woodley FW, Ciciora SL, Vaz K, Williams K, Di Lorenzo C. Should all a symptomatic infants under the age of 12 months undergoing impedance testing be assessed for aerophagia? Abstracts of the 19th ANMS Annual Meeting, August, 2021, Boston, USA. P. 43-44.

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Авторы: Woodley F.W.  / Ciciora S.L. / Vaz K.K.H. / Williams K.C.  / Di Lorenzo C.


Should all a symptomatic infants under the age of 12 months undergoing impedance testing be assessed for aerophagia?

Перевод на русский язык

F.W. Woodley, S.L. Ciciora, K. Vaz, K. Williams, C. Di Lorenzo

Division of Gastroenterology, Hepatology and Nutrition, Nationwide Children’s Hospital, Columbus, OH.

Background: Gastroesophageal reflux (GER) and air swallowing are both common in infants. While the association of GER with symptoms in infants has been well studied, the association of air swallows with similar symptoms has not. We recently showed that a novel application of multichannel intraluminal impedance and pH monitoring (MII-pH) can be used to objectively assess the temporal relationship between air swallows and GER-like symptoms.

Aim: The purpose of this investigation was to assess the roll of air swallowing in infants presenting with symptoms suggestive of GER as an etiology.

Methods: We searched our MMS data base for infants (≤12 months) who had been tested using MII-pH from 2014 to 2020. Tracings were excluded if there were significant technical defects or if recording time during non-feeding periods was < 15 hours. Two copies were made of each tracing; the first copy was used to manually tag GER events and the second copy was used to manually tag air swallows. For both tracings, temporal association was tested using the symptom association probability (SAP) index with a positive association set at > 95%.

Results: Forty-five infants were enrolled (21 F). Age (median [IQR]) was 6.9 [4.8–9.3] months, acid reflux index was 2.1 [0.6–3.9]%, and percent bolus exposure was 0.98 [0.55–1.39] %. Forty infants (87%) were on anti-reflux medications that included PPI (30; 65%), histamine-2 receptor antagonist (11; 24%), erythromycin (2; 4%) and baclofen (1; 2%). Air swallowing occurred in all subjects with a median [IQR] number/hr. of 7.6 [3.4–11.3] (total), 0.32 [0.17–0.66] (acidified esophagus), and 7.0 [3.4–11.1] (non-acidified esophagus). Significantly more air swallows occurred when the esophagus was not acidified (92.2% vs 7.8%, p < 0.0001). In 8 (17.8%) infants, symptoms were significantly associated with only GER. In 38 (84.4%) infants, symptoms were significantly associated with either GER or air swallows. In 14 (36.8%) infants, symptoms were significantly associated with only air swallows.

Discussion: The data show that air swallows are indeed common in infants. In a study involving a moderately-sized cohort, the data also show that in the absence of MII-pH analyses that includes air swallowing more than a third of infants may not receive a diagnosis.




Woodley FW, Ciciora SL, Vaz K, Williams K, Di Lorenzo C. Should all a symptomatic infants under the age of 12 months undergoing impedance testing be assessed for aerophagia? Abstracts of the 19th American Neurogastroenterology and Motility Society Annual Scientific Meeting, August 13–15, 2021, Boston, Massachusetts, USA. № 97.

Neurogastroenterology & Motility. 2021;33(Suppl. 1):e14230. P. 43-44. wileyonlinelibrary.com/journal/nmo



Некоторые другие материалы 19-ой ежегодной конференции ANMS, 2021 г.

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