Gastroesophageal Reflux and Gastric Emptying

Abstract

Gastroesophageal reflux (GER) may be defined as a dysfunction of the distal esophagus causing return of gastric contents into the esophagus.¹³ GER is a rather common problem during infancy, with an incidence estimated as 1 in 500 infants. The common clinical manifestations of GER can be attributed to the regurgitation of acidic gastric contents into the esophagus. In reviewing the symptomatology associated with GER, Weissbluth²⁸ summarized the clinical features in 1070 children with GER. Vomiting occurred in two-thirds of the children, usually beginning at birth, and frequently associated with loss of appetite resulting in weight loss or failure to thrive. Twenty-eight percent of the children exhibited bleeding secondary to esophagitis caused by erosion of the lower esophageal mucosa. Nineteen percent of the patients had associated respiratory symptomatology.²⁷ Symptoms frequently will mimic those of allergic bronchitis, asthma, or recurrent episodes of pneumonitis. The findings of airway disease in association with reflux do not suggest a causal relationship. However, a series reported by Berquist et al.³ revealed a significant improvement in respiratory symptomatology upon medical or surgical therapy for GER.