Pediatr Gastroenterol Hepatol Nutr.  2015 Dec;18(4):238-245. 10.5223/pghn.2015.18.4.238.

Esophageal Bolus Transit in Newborns with Gastroesophageal Reflux Disease Symptoms: A Multichannel Intraluminal Impedance Study

• Cresi F
• Liguori SA
• Maggiora E
• Locatelli
• Indrio F
• Bertino E
• Coscia A

• KMID: 2383301
• DOI: http://doi.org/10.5223/pghn.2015.18.4.238

Abstract

PURPOSE
The aim of this study was to evaluate bolus transit during esophageal swallow (ES) and gastroesophageal reflux (GER) events and to investigate the relationship between the characteristics of ES and GER events in a population of term and preterm newborns with symptoms of gastroesophageal reflux disease (GERD).
METHODS
The study population consisted of term and preterm newborns referred to combined multichannel intraluminal impedance (MII) and pH monitoring for GERD symptoms. The frequency and characteristics of ES and GER events were assessed by two independent investigators. Statistical significance was set at p<0.05.
RESULTS
Fifty-four newborns (23 preterm) were included in the analyses. Median bolus head advancing time corrected for esophageal length (BHATc) was shorter during mealtime than during the postprandial period (median, interquartile range): 0.20 (0.15-0.29) s/cm vs. 0.47 (0.39-0.64) s/cm, p<0.001. Median bolus presence time (BPT) was prolonged during mealtime: 4.71(3.49-6.27) s vs. 2.66 (1.82-3.73) s, p<0.001. Higher BHATc (p=0.03) and prolonged BPT (p<0.001) were observed in preterm newborns during the postprandial period. A significant positive correlation between BHATc and bolus clearance time was also observed (rho=0.33, p=0.016).
CONCLUSION
The analysis of ES and GER events at the same time by MII provides useful information to better understand the physiopathology of GERD. In particular, the analysis of BHATc during the postprandial period could help clinicians identify newborns with prolonged esophageal clearance time due to impaired esophageal motility, which could allow for more accurate recommendations regarding further tests and treatment.

Keyword

Esophageal swallow; Gastroesophageal reflux; Esophageal impedance; Newborn; Premature birth

MeSH Terms

Electric Impedance*
Gastroesophageal Reflux*
Head
Humans
Hydrogen-Ion Concentration
Infant, Newborn*
Meals
Postprandial Period
Premature Birth
Research Personnel

Figure

• 

  Fig. 1 Impedance characteristics of esophageal swallow (ES) events during mealtime and the postprandial period. Ch.: impedance channel, BHAT: bolus head advancing time, BPT: bolus presence time.

• 

  Fig. 2 Spearman correlation for bolus head advancing time corrected for esophageal length (BHATc) and bolus clearance time (BCT).

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