Gastroesophageal reflux in children

Description

Introduction Contents 1: Epidemiology of GER Introduction Epidemiological Pitfalls GER and Regurgitation in Infants Effect of Feeding GERD in Infancy GER(D) in Children and Adolescents Potential Risk Factors for GERD Genetic Factors Smoking and Alcohol Preterm Infants Comorbidity Conclusion References 2: Pathophysiology of GER LES Function Other Structural Abnormalities Esophageal Mechanisms Esophageal Peristalsis Esophageal Mucosa Defense Mucosal Integrity Sensation Special Patient Groups Conclusion References 3: Symptoms of GER Introduction Clinical Picture of Physiologic GER and GERD in Infants Clinical Picture of GERD in Young Children Clinical Picture of GERD in Older Children and Adolescents Overview on GERD and Respiratory Symptoms References 4: Dysphagia and GER Introduction Pathophysiology of Swallowing Genesis of Dysphagia in Patients with GERD Clinical Presentation Diagnosis Treatment Conclusion References 5: Duodeno-GER Introduction Mechanism of Bile Injury Luminal Factors Responsible of Impaired Mucosal Integrity Measurement of Duodenogastroesophageal Reflux Esophageal pH Monitoring/Impedance Bilirubin Monitoring HIDA Scintigraphy Aspiration Study Other Role of Duodenogastroesophageal Reflux in Esophageal Lesions Role of Duodenogastroesophageal Reflux in Symptoms The Role of Duodenogastroesophageal Reflux in Neoplasia Therapeutic Implications References 6: GER in Preterm Infants Introduction Diagnosis Clinical Evaluation Multichannel Intraluminal Impedance and pH Monitoring (MII-pH) Other Diagnostic Tools Use of Proton Pump Inhibitors as a Diagnostic Test Use of Extensively Hydrolyzed Protein Formula as a Diagnostic Test Treatment Conservative Approach Improvement of Feeding Tolerance Use of Hydrolized Protein Formula Medications First-Line Treatments Second-Line Treatments References 7: GER and Respiratory Diseases Introduction Mechanisms of Association Between GER and Respiratory Disease GER and Asthma Pathogenetic Mechanisms The Role of Anti-acid Drugs in Asthma GER and Chronic Cough Pathogenetic Mechanisms The Role of Anti-acid Drugs for Chronic Cough GER and Laryngopharyngeal Disease The Role of Anti-acid Drugs for Laryngopharyngeal Disease Conclusion References 8: GER and Apnea Introduction Pathogenic Links Apnoea, ALTE, and GER(D) APNOEA and GER(D): Studies in Infants ALTE and GER(D) Studies in Children OSAS and GER Conclusion References 9: GER in Cystic Fibrosis Introduction Gastroesophageal Reflux and Gastroesophageal Reflux Disease Cystic Fibrosis What is the Mechanism of Increased GER in CF? Esophageal Motility in CF Incidence of GER and GERD in Children with CF Incidence of GER in Adults with CF Diagnosing GERD in CF Relationship Between GER and Worsening Lung Function in People with CF Delayed Gastric Emptying and GERD Barrett’s Esophagus and Esophageal and Gastroesophageal Junction Adenocarcinoma in CF Evidence of Aspiration in Children with CF How does GER Differ Between Children with CF and Symptomatic Children Without CF? Aging in CF: Impact on GER Treatments for GERD in CF PPI/H2RA/Prokinetics Lifestyle Changes Nissen Fundoplication What is on the Horizon? Conclusion References 10: GER and Esophageal Atresia Introduction GERD is Frequent in Patients with EA GERD is Associated with Complications in Neonates and Infants Operated for EA GERD Impacts Quality of Life of EA Patients What is the Natural History of GERD in EA Patients? How Should GERD be Diagnosed in EA Patients? How Should GERD be Treated in EA Patients? Should GERD Systematically be Treated with PPI in all EA Patients? How Long Should GERD be Treated and Monitored? Is Routine Endoscopy Useful in the Follow-up of EA Patients? When do We Perform Fundoplication in EA Patients with GERD? What Evaluations Should be Performed Prior to Fundoplication? What are the Long-Term Morbidities of GERD in Adults with EA? Conclusion References 11: GERD and Cow’s Milk Allergy Introduction The Role of Cow’s Milk Protein (CMP) in GERD Diagnosis Dietary Management in Proven CMP-Induced GERD Breastmilk in the Management of GERD Formulas for CMA in the Management of GERD Complementary Feeding in Infants with GERD Natural History of CMP-Induced GERD Conclusion References 12: GER and Overweight/Obesity Introduction and Epidemiology Pathophysiology Other Associations Specific Treatment Options References 13: GER and Eosinophilic Esophagitis Conclusion References 14: GER and Helicobacter pylori Introduction Diagnosis of GERD Diagnosis of H. pylori H. pylori Pathogenesis in Children H. pylori and GERD The Effects on Children H. pylori and Reflux Esophagitis (RE) Atrophic Gastritis The Effect of H. pylori Eradication on GERD Barrett’s Esophagus Effects of H. pylori Infection on Gastrin, Ghrelin, and GERD GERD, H. pylori and Gastrin GERD, H. pylori, and Pepsinogens (PGs) GERD, H. pylori, and Ghrelin Virulence Factors of H. pylori, and GERD Virulence Factors of H. pylori Cytotoxin-Associated Gene A (CagA) Vacuolation Cytotoxin A (VacA) Duodenal Ulcer Promoting Gene A Protein (DupA) Outer Inflammatory Protein (OipA) Adherence and Outer Membrane Proteins (OMPs) Inflammatory Cytokines of H. pylori, and GERD H. pylori and Gastric Microbiota in Children Limitation Conclusion References 15: GER and Probiotic The Infant with Uncomplicated Recurrent Regurgitation The Infant with Recurrent Regurgitation and Poor Weight Gain The Child over 18 Months of Age with Chronic Regurgitation or Vomiting Role of Probiotics Probiotics and PPI Possible Effect of Probiotic Treatment Microbiota–Gut–Brain Axis Conclusion References 16: Diagnosis of GERD Introduction History, Physical Exam, and Questionnaires Typical Symptoms Infants Older Children and Adolescents Extra-Esophageal Symptoms Diagnostic Tests Proton Pump Inhibitor (PPI) Trial Endoscopy and Esophageal Biopsies Function Tests High-Resolution Manometry 24-Hour Esophageal pH—Monitoring 24-Hour Esophageal pH-Impedance Monitoring Function Testing in Extra-Esophageal Symptoms Other Tests Imaging Non-invasive Tests Conclusion References 17: Contribution of Histology to the Diagnosis of GER Introduction Histology of the Esophagus and Reflux Esophagitis Normal Esophagus Biopsies Histological Lesions in Gastroesophageal Reflux Disease Where to Take Biopsies? How Many Biopsies? Correlation of Histology to GERD in Children Symptoms Infants Child and Adolescent Endoscopy pHmetry Esophageal Impedance Baseline Impedance Contractile Segment Impedance Contribution of Histology to Diagnostic of GERD Identifying the Differential Diagnosis Screening for Barrett’s Esophagus In Specific Situations Esophageal Atresia (EA) Neurologically impaired Children Cystic Fibrosis (CF) Conclusion References 18: How to Position pH-Impedance Probes in Pediatric Patients Introduction Formulas Proposed in Literature The KidZ Health Castle Formula References 19: Esophageal Clearance in GERD Clearance of Gastroesophageal Reflux Volume Clearance Chemical Clearance Esophageal Motility Disorders Measuring Esophageal Clearance Modifiers of Esophageal Clearance References 20: Manometry Introduction Practicalities of Performing Esophageal HRM Studies in Children What Can Esophageal HRM Measure That Is Relevant to GER Disease? Excluding Achalasia Ineffective Esophageal Motility Mucosal Impedance Additive Value Multiple Rapid Swallows Transient LES Relaxation Esophago-Gastric Junction Morphology Esophago-gastric Junction Contractility Pre-operative HRM to Identify Pediatric Patients at Risk Postoperative Dysphagia Use of Manometry with Impedance to Investigate Rumination Syndrome Conclusion References 21: Nuclear Scintigraphy and GER References 22: Acid-Lowering Drugs for the Treatment of Gastro-esophageal Reflux Disease Introduction Medical Management of GERD Antacid and Alginate Formulations Pharmacology Clinical Efficacy Antisecretory Drugs Regulation of Gastric Acid Secretion Pharmacology of H2-Receptor Antagonists Formulations of H2-Receptor Antagonists Pharmacology of Proton Pump Inhibitors Pharmacogenetics of Proton Pump Inhibitors Formulations of Proton Pump Inhibitors Non-Antisecretory Effects of H2-Receptor Antagonists and Proton Pump Inhibitors Clinical Efficacy of H2-Receptor Antagonists Clinical Efficacy of Proton Pump Inhibitors Overuse and Misuse of Antisecretory Therapy Acid Suppression Drugs: What Is New? Conclusions References 23: Anti-Acid Drugs: Adverse Effects Introduction Antacids Magnesium Hydroxide and Aluminum Hydroxide Sodium and/or Magnesium Alginates Acid Suppressive Drugs H2-Receptor Antagonist Proton Pomp Inhibitors Potassium-Competitive Acid Blockers Conclusion References 24: GER and Prokinetics Metoclopramide Bromopride Bethanechol Cisapride Domperidone Drugs Acting on Lower Esophageal Sphincter References 25: Adverse Effects of GER Medication Except Anti-Acid Drugs Introduction Prokinetics Metoclopramide Domperidone Cisapride Erythromycin Bethanechol Baclofen Conclusion References 26: GER and Hypnotherapy Introduction What Is Hypnosis? Hypnosis and Gastric Functioning Hypnotherapy and Gastric Symptoms Future Directions References 27: Alternative Medicine and Lifestyle Changes in GERD Introduction Weight Loss in Obesity Massage Therapy Acupuncture Mind–Body Therapies Herbs and Dietary Supplements Summary References 28: GERD and Endoscopic Therapeutic Approach Introduction Endoscopic Suturing Devices Full Thickness Plicator® EsophyX® Delivery of Radiofrequency Energy (Stretta® System) Gastro-esophageal Biopolymer Injection Conclusion References 29: Surgical Options to Treat GERD Introduction For a Successful Surgical Treatment, Three Conditions Need to be Fulfilled: Careful Selection of the Candidates for Surgery After a Complete Pre-Operative Work-Up, and a Technically Correct Operation Preoperative Work-Up for Anti-reflux Surgery Indications for Anti-Reflux: Surgery Surgical Technique The History of Anti-Reflux Surgery [15] Laparoscopic Fundoplication (Nissen Procedure) Partial Fundoplication Esophagogastric Disconnection Additional (Concomitant) Procedures Complications of Anti-reflux Surgery Intra-Operative Complications Postoperative Complications Results of Anti-reflux Surgery Conclusion References Index