scholarly journals Diagnosis and Treatment of Gastroesophageal Reflux Disease in Infants and Children

2000 ◽  
Vol 14 (suppl d) ◽  
pp. 26D-34D ◽  
Author(s):  
Yvan Vandenplas
Keyword(s):  
Gastroesophageal Reflux Disease ◽  
Gastroesophageal Reflux ◽  
Reflux Disease ◽  
Ph Monitoring ◽  
Chronic Respiratory Disease ◽  
Esophageal Ph Monitoring ◽  
Infants And Children ◽  
Dietary Recommendations ◽  
Esophageal Ph ◽  
In Infants And Children

Gastroesophageal reflux is a frequent, nonspecific phenomenon in infants and children. The recommended approach for infants with uncomplicated regurgitation is the reassurance of the parents about the physiological nature of excessive regurgitation, and if necessary, completed with dietary recommendations for formula-fed infants. If, despite these efforts, the symptoms persist, the administration of prokinetics such as cisapride is recommended before investigations such as esophageal pH monitoring are begun. Cisapride is the drug of choice because it has the best efficacy and safety profile. In infants and children presenting with symptoms that suggest esophagitis, endoscopy of the upper gastrointestinal tract is recommended. If there is severe esophagitis, acid suppression with H2receptor antagonists or proton pomp inhibitors is recommended, eventually in combination with prokinetics. In life-threatening situations, or in patients who are resistant to or dependent on acid suppressive medication, a surgical procedure such as laparoscopic Nissen should be considered.Esophageal pH monitoring is recommended to document gastroesophageal reflux disease in children presenting with unusual presentations such as chronic respiratory disease. Treatment consists of prokinetics and/or acid suppressive drugs, and surgery should be considered in many of these patients.

scholarly journals Research on Gastroesophageal Reflux Disease Based on Dynamic Features of Ambulatory 24-Hour Esophageal pH Monitoring

2017 ◽  
Vol 2017 ◽  
pp. 1-7
Author(s):  
Shuang Liu ◽  
Minpeng Xu ◽  
Jiajia Yang ◽  
Hongzhi Qi ◽  
Feng He ◽  
...  
Keyword(s):  
Gastroesophageal Reflux Disease ◽  
Gastroesophageal Reflux ◽  
Information Entropy ◽  
Reflux Disease ◽  
Ph Monitoring ◽  
Esophageal Ph Monitoring ◽  
Dynamic Features ◽  
Recording Time ◽  
Wavelet Energy ◽  
Esophageal Ph

Ambulatory 24-hour esophageal pH monitoring has been considered as the gold standard for diagnosing gastroesophageal reflux disease (GERD), and in clinical application, static parameters are widely used, such as DeMeester score. However, a shortcoming of these static variables is their relatively high false negative rate and long recording time required. They may be falsely labeled as nonrefluxers and not appropriately treated. Therefore, it is necessary to seek more accurate and objective parameters to detect and quantify GERD. This paper first describes a new effort that investigated the feasibility of dynamic features of 24-hour pH recording. Wavelet energy, information entropy, and wavelet entropy were estimated for three groups (severe, mild-to-moderate, and normal). The results suggest that wavelet energy and entropy are physiologically meaningful since they differentiated patients with varying degrees of GERD.K-means clustering algorithm was employed to obtain the sensitivity and specificity of new parameters. It is obvious that information entropy goes with the highest sensitivity of 87.3% and wavelet energy has the highest specificity of 97.1%. This would allow a more accurate definition of the best indicators to detect and quantify GERD as well as provide an alternative insight into the early diagnosis of GERD.

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