J Neurogastroenterol Motil.  2012 Oct;18(4):406-411.

Functional Gastrointestinal Disorders Induced by Esophageal Atresia Surgery: Is It Valid in Humans?

Affiliations
  • 1Division of Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, Sainte-Justine Hospital, Universite de Montreal, Montreal, Quebec, Canada. ugur.halac@umontreal.ca
  • 2Division of Gastroenterology, Hepatology and Nutrition, and Reference Centre for Congenital and Malformative Oesophageal Diseases, Department of Paediatrics, Jeanne de Flandre Children's Hospital and Faculty of Medicine, University Lille 2, Lille, France.

Abstract

BACKGROUND/AIMS
Functional gastrointestinal disorders (FGID) affect 15%-20% of the general pediatric and adult population. Animal models suggest that a neonatal stress such as invasive procedures and maternal separation could be responsible for visceral hypersensitivity and FGID. We tested the hypothesis that congenital esophageal atresia (EA), a condition corrected during the neonatal period and associated with multiple stresses, is a clinically significant risk factor for the development of FGID later in life. We postulated that, to be clinically significant, the effect of neonatal stress on the incidence of FGID should be as strong as that of enteric infections in the development of irritable bowel syndrome in children.
METHODS
Subjects with EA and healthy controls were enrolled in this multicenter cohort study. Gastrointestinal symptoms were assessed by a questionnaire and FGID was diagnosed using the Rome III criteria.
RESULTS
Fifty-three children (25 girls; median age, 12 years) with EA were compared to 72 age- and sex-matched controls. Although 11 children with EA (21%) had a FGID diagnosis versus 8 controls (11%), this difference was not significant (chi2 = 2.20, P > 0.05). In subjects with EA, the presence of associated malformations, the occurrence of complications during the first month, and the length of hospital stay > 30 days did not influence the incidence of FGID. Chronic abdominal pain was present in 38% of subjects with EA versus 25% of controls (P > 0.05).
CONCLUSIONS
Neonatal stress secondary to surgical correction of EA is not a clinically significant risk factor for the development of FGID in childhood.

Keyword

Esophageal atresia; Irritable bowel syndrome; Life change events

MeSH Terms

Abdominal Pain
Adult
Child
Cohort Studies
Esophageal Atresia
Gastrointestinal Diseases
Humans
Hypersensitivity
Incidence
Irritable Bowel Syndrome
Length of Stay
Life Change Events
Models, Animal
Surveys and Questionnaires
Risk Factors
Rome
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