Small volumes of feed can trigger transient lower esophageal sphincter relaxation and gastroesophageal reflux in the right lateral position in infants

The Journal of Pediatrics
M van WijkT Omari

Abstract

To investigate the threshold amount of constantly infused feed needed to trigger lower esophageal sphincter relaxation (TLESR) in the right lateral position (RLP) and left lateral position (LLP). Eight healthy infants (3 male; gestational age: 32.9 +/- 2.4 weeks; corrected age: 36.1 +/- 1.3 weeks) were studied using an esophageal impedance-manometry catheter incorporating an intragastric infusion port. After tube placement, infants were randomly positioned in RLP or LLP. They were then tube-fed their normal feed (62.5 [40 to 75] mL) at an infusion rate of 160 mL/h. Recordings were made during the feed and 15 minutes thereafter. The study was repeated with the infant in the opposite position. More TLESRs were triggered in the RLP compared with LLP (4.0 [3.0 to 6.0] vs 2.5 [1.0 to 3.0], P = .027). First TLESR occurred at a significantly lower infused volume in RLP compared with LLP (10.6 +/- 9.4 vs 21.0 +/- 4.9 mL, P = .006). The percentage of feed infused at time of first TLESR was significantly lower in RLP compared with LLP (17.6% +/- 15.5% vs 35.4% +/- 8.02%, P = .005). In the RLP, TLESRs and gastroesophageal reflux are triggered at volumes unlikely to induce gastric distension.

References

Aug 1, 1995·Gastroenterology·R K MittalJ Dent
Sep 1, 1995·Neurogastroenterology and Motility : the Official Journal of the European Gastrointestinal Motility Society·G S HebbardJ Dent
Nov 20, 1998·The Journal of Pediatrics·T I OmariJ Dent
Dec 5, 2002·Neurogastroenterology and Motility : the Official Journal of the European Gastrointestinal Motility Society·R C H SchefferH G Gooszen
Apr 17, 2009·Neurogastroenterology and Motility : the Official Journal of the European Gastrointestinal Motility Society·M P van WijkT I Omari

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Citations

Sep 3, 2013·Current Opinion in Pediatrics·David ForbesMadhur Ravikumara
Oct 16, 2013·Nature Reviews. Gastroenterology & Hepatology·Yvan Vandenplas
Jun 4, 2014·Nature Reviews. Gastroenterology & Hepatology·Maartje M J SingendonkMichiel P van Wijk
Apr 29, 2015·Expert Opinion on Drug Safety·Marc Bardou, Kyle J Fortinsky
Sep 8, 2012·Clinics in Perinatology·Sudarshan R Jadcherla
Jan 20, 2012·Neurogastroenterology and Motility : the Official Journal of the European Gastrointestinal Motility Society·W O RohofG E Boeckxstaens
Nov 30, 2012·Neurogastroenterology and Motility : the Official Journal of the European Gastrointestinal Motility Society·C LootsM van Wijk
Jul 24, 2013·Gastroenterology Research and Practice·Luigi CorvagliaGiacomo Faldella
May 5, 2016·Gastroenterology·Marc A BenningaSamuel Nurko
Dec 6, 2016·Archives de pédiatrie : organe officiel de la Sociéte française de pédiatrie·M BellaïcheP Clerson
Apr 16, 2014·Journal of Pediatric Gastroenterology and Nutrition·Clara LootsTaher Omari
Apr 13, 2017·Pediatric Gastroenterology, Hepatology & Nutrition·Judith ZeevenhoovenMarc A Benninga
Jan 16, 2016·Pediatric Gastroenterology, Hepatology & Nutrition·Francesco CresiAlessandra Coscia
Nov 30, 2018·Expert Opinion on Pharmacotherapy·Marc BardouAlan Barkun

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