The Relationship Between Somatic Growth and in Vivo Esophageal Segmental and Sphincteric Growth in Human Neonates

Overview

Journal J Pediatr Gastroenterol Nutr

Publisher Wiley

Date 2006 Jul 5

PMID 16819375

Citations 26

Authors

Alankar Gupta

Sudarshan Rao Jadcherla

Affiliations

Soon will be listed here.

Abstract

Background: Measurement of aerodigestive tract length is an important determinant for accurate placement of esophageal probes and gavage tubes at the desired location. The relationship of esophageal body, upper esophageal sphincter (UES) and lower esophageal sphincter (LES) lengths with somatic growth in neonates is not well understood.

Objectives: Our objectives were to (1) evaluate a relationship between segmental esophageal lengths and somatic growth parameters and (2) ascertain the relationship between segmental esophageal lengths and gestational age (GA) and postmenstrual age (PMA) in preterm and full-term born human neonates.

Design/methods: One hundred esophageal manometry studies were performed in 75 infants (30-60 weeks PMA) and the high-pressure zones of LES and UES identified. The distance from nares to LES and from nares to UES, esophageal body length, length of UES and LES derived from the manometry studies were correlated with somatic growth parameters. Growth rate of different esophageal segments was also determined in 26 subjects that underwent longitudinal studies. Analysis of variance and linear regression analysis were performed.

Results: Seventy-five neonates of 23.0-40.6 weeks gestational age (0.6-4.4 kg) were studied at 29.1-58.6 weeks PMA (1.0-6.4 kg). Significant correlation (P < 0.001) of PMA and physical growth parameters with the growth of nares-LES (R = 0.8), esophageal body length (R = 0.6) and nares-UES (R = 0.4) were noted. Nares-to-LES length increased at a rate of 0.25 cm/wk PMA during 33.0-36.0 weeks of age.

Conclusions: In vivo esophageal segmental lengths correlated strongly with somatic growth parameters and PMA in neonates. We speculate that this approach has many practical applications with the use of esophageal probes and catheters.

Citing Articles

Pharyngeal biorhythms during oral milk challenge in high-risk infants: Do they predict chronic tube feeding?.

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Symptom Scores and pH-Impedance: Secondary Analysis of a Randomized Controlled Trial in Infants Treated for Gastroesophageal Reflux.

Sultana Z, Hasenstab K, Moore R, Osborn E, Yildiz V, Wei L Gastro Hep Adv. 2022; 1(5):869-881.

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Continuous versus bolus intermittent intragastric tube feeding for preterm and low birth weight infants with gastro-oesophageal reflux disease.

Richards R, Foster J, Psaila K Cochrane Database Syst Rev. 2021; 8:CD009719.

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Characterization of Esophageal and Sphincter Reflexes across Maturation in Dysphagic Infants with Oral Feeding Success vs Infants requiring Gastrostomy.

Swiader N, Hasenstab K, Yildiz V, Jadcherla S Dysphagia. 2021; 37(1):148-157.

PMID: 33576892 DOI: 10.1007/s00455-021-10258-8.

Impact of Feeding Strategies With Acid Suppression on Esophageal Reflexes in Human Neonates With Gastroesophageal Reflux Disease: A Single-Blinded Randomized Clinical Trial.

Jadcherla S, Hasenstab K, Gulati I, Helmick R, Ipek H, Yildiz V Clin Transl Gastroenterol. 2020; 11(11):e00249.

PMID: 33259163 PMC: 7643906. DOI: 10.14309/ctg.0000000000000249.

References

Jadcherla S, Duong H, Hofmann C, Hoffmann R, Shaker R . Characteristics of upper oesophageal sphincter and oesophageal body during maturation in healthy human neonates compared with adults. Neurogastroenterol Motil. 2005; 17(5):663-70. DOI: 10.1111/j.1365-2982.2005.00706.x. View

Sifrim D . Relevance of volume and proximal extent of reflux in gastro-oesophageal reflux disease. Gut. 2005; 54(2):175-8. PMC: 1774852. DOI: 10.1136/gut.2004.043984. View

Di Lorenzo C, Hillemeier C, Hyman P, Loening-Baucke V, Nurko S, Rosenberg A . Manometry studies in children: minimum standards for procedures. Neurogastroenterol Motil. 2002; 14(4):411-20. DOI: 10.1046/j.1365-2982.2002.00347.x. View

Wenzl T, Schneider S, Scheele F, Silny J, Heimann G, Skopnik H . Effects of thickened feeding on gastroesophageal reflux in infants: a placebo-controlled crossover study using intraluminal impedance. Pediatrics. 2003; 111(4 Pt 1):e355-9. DOI: 10.1542/peds.111.4.e355. View

Jadcherla S, Duong H, Hoffmann R, Shaker R . Esophageal body and upper esophageal sphincter motor responses to esophageal provocation during maturation in preterm newborns. J Pediatr. 2003; 143(1):31-8. DOI: 10.1016/S0022-3476(03)00242-7. View

Pehl C, Boccali I, Hennig M, Schepp W . pH probe positioning for 24-hour pH-metry by manometry or pH step-up. Eur J Gastroenterol Hepatol. 2004; 16(4):375-82. DOI: 10.1097/00042737-200404000-00002. View

Gehan E, George S . Estimation of human body surface area from height and weight. Cancer Chemother Rep. 1970; 54(4):225-35. View

Euler A, Ament M . Detection of gastroesophageal reflux in the pediatric-age patient by esophageal intraluminal pH probe measurement (Tuttle test). Pediatrics. 1977; 60(1):65-8. View

Strobel C, Byrne W, Ament M, Euler A . Correlation of esophageal lengths in children with height: application to the Tuttle test without prior esophageal manometry. J Pediatr. 1979; 94(1):81-4. DOI: 10.1016/s0022-3476(79)80361-3. View

10.

Jolley S, Tunell W, Carson J, SMITH E, Grunow J . The accuracy of abbreviated esophageal pH monitoring in children. J Pediatr Surg. 1984; 19(6):848-54. DOI: 10.1016/s0022-3468(84)80383-8. View

11.

Mosteller R . Simplified calculation of body-surface area. N Engl J Med. 1987; 317(17):1098. DOI: 10.1056/NEJM198710223171717. View

12.

Newell S, Sarkar P, Durbin G, Booth I, McNeish A . Maturation of the lower oesophageal sphincter in the preterm baby. Gut. 1988; 29(2):167-72. PMC: 1433285. DOI: 10.1136/gut.29.2.167. View

13.

Mittal R, McCallum R . Characteristics and frequency of transient relaxations of the lower esophageal sphincter in patients with reflux esophagitis. Gastroenterology. 1988; 95(3):593-9. DOI: 10.1016/s0016-5085(88)80003-9. View

14.

Sutphen J . Pediatric gastroesophageal reflux disease. Gastroenterol Clin North Am. 1990; 19(3):617-29. View

15.

Klauser A, Schindlbeck N, Muller-Lissner S . Esophageal 24-h pH monitoring: is prior manometry necessary for correct positioning of the electrode?. Am J Gastroenterol. 1990; 85(11):1463-7. View

16.

Putnam P, Orenstein S . Determining esophageal length from crown-rump length. J Pediatr Gastroenterol Nutr. 1991; 13(4):354-9. DOI: 10.1097/00005176-199111000-00004. View

17.

. American Gastroenterological Association medical position statement: guidelines on the use of esophageal pH recording. Gastroenterology. 1996; 110(6):1981. DOI: 10.1053/gast.1996.1101981. View

18.

Nelson S, Chen E, Syniar G, Christoffel K . Prevalence of symptoms of gastroesophageal reflux during infancy. A pediatric practice-based survey. Pediatric Practice Research Group. Arch Pediatr Adolesc Med. 1997; 151(6):569-72. DOI: 10.1001/archpedi.1997.02170430035007. View

19.

Orenstein S . Infantile reflux: different from adult reflux. Am J Med. 1998; 103(5A):114S-119S. DOI: 10.1016/s0002-9343(97)00335-5. View

20.

Nelson S, Chen E, Syniar G, Christoffel K . One-year follow-up of symptoms of gastroesophageal reflux during infancy. Pediatric Practice Research Group. Pediatrics. 1998; 102(6):E67. DOI: 10.1542/peds.102.6.e67. View