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Gastroesophageal Reflux and Esophageal Atresia

  • Frederic Gottrand
  • Madeleine Gottrand
  • Rony Sfeir
  • Laurent Michaud
Chapter

Abstract

Esophageal atresia (EA) with or without tracheoesophageal fistula (TEF) is one of the most common digestive malformations. Although mortality decreased dramatically to less than 10%, digestive problems remain frequent in children with EA both in early infancy and at long-term follow-up. These patients are at major risk of presenting gastroesophageal reflux (GER) and its complications, as anastomotic strictures, esophagitis, failure to thrive, and Barrett’s esophagus. Concerns in adults include esophageal adenocarcinoma and epidermoid carcinoma which have been recently been reported. Although there was a lack of recommendation, a recent guideline for the management of GI complications has been published to help formulate clinical practice guidelines for the care of EA patients. It is recommended that GER be treated with PPI in all EA patients in the neonatal period up to the first year of life or longer depending on persistence of GER. Endoscopy with biopsies is mandatory for routine monitoring of GERD in patients with EA. All EA patients (including asymptomatics) should undergo monitoring of GER (impedance/pH-metry, and/or endoscopy) at time of discontinuation of antiacid treatment and during long-term follow-up. Routine endoscopy in asymptomatic EA patients is recommended. The expert panel recommends three endoscopies throughout childhood (one after stopping PPI therapy, one before the age of 10, one at transition to adulthood). Patients with EA need a systematic follow-up with a multidisciplinary team.

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© Springer International Publishing AG 2017

Authors and Affiliations

  • Frederic Gottrand
    • 1
  • Madeleine Gottrand
    • 1
  • Rony Sfeir
    • 1
  • Laurent Michaud
    • 1
  1. 1.National Reference Center for Congenital Malformation of the Esophagus, Department of PediatricsCHU Lille, Univ. LilleLilleFrance

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