Featured Research

from universities, journals, and other organizations

New study helps clarify symptoms and characteristics of acid reflux in neonates

Date:
August 8, 2011
Source:
Nationwide Children's Hospital
Summary:
Modifying stomach acid levels may not be enough to treat symptoms in neonates suspected of having gastroesophageal reflux disease. This is the first study to classify reflux and its associated symptoms in neonates based on how and what is refluxed.

Modifying stomach acid levels may not be enough to treat symptoms in neonates suspected of having gastroesophageal reflux disease. According to research from Nationwide Children's Hospital, this is the first study to classify reflux and its associated symptoms in neonates based on how and what is refluxed.

Related Articles


Gastroesophageal reflux disease (GERD) is a frequent consideration in infants at risk of the life-threatening events chronic lung disease and dysphagia. Yet, the definition of GERD in neonates and infants and its treatment remains controversial. Acid suppressive medications and prokinetics are commonly prescribed to alter gastric acidity and improve gastrointestinal motility in neonates, yet such therapies can have harmful side effects.

"It's difficult to distinguish whether symptoms of reflux are part of a neonate's normal functioning or if they are disease-based," said study author, Sudarshan Jadcherla, MD, FRCPI, DCH, AGAF, neonatology and principal investigator in the Center for Perinatal Research of The Research Institute at Nationwide Children's Hospital. "As such, there are no definite standards to aid in the management of reflux among neonates in the intensive care unit, nor clarity regarding symptom recognition, nor standards to aid in the diagnosis of GERD."

Dr. Jadcherla, also medical director of the Neonatal and Infant Feeding Disorders Program and professor of Pediatrics at The Ohio State University College of Medicine and Public Health, says that establishing objective evidence of gastroesophageal reflux events and the relationship of symptoms with the physical or chemical composition of the refluxate is essential to characterize whether patients have a disease that needs treatment.

To help characterize reflux events, Nationwide Children's investigators evaluated 30 neonates in Nationwide Children's NICU who were suspected to have GERD. Using pH-impedance studies, the team determined refluxate presence, composition, distribution and clearing time. Nurses also documented whether the neonates showed any respiratory symptoms (coughing, gagging, grunting), sensory symptoms (irritability, grimacing, crying) or physical movement such as stretching of their limbs, during the identified reflux events.

Findings of the study, published in the journal Pediatric Research, showed that:

  • Non-acid reflux events are of equal frequency as acid reflux events and the majority of events spread proximally above the upper esophageal sphincter.
  • Acid clearance time per acid ph-impedance event was lesser than ph-only events.
  • Infra-upper esophageal sphincter reflux was correlated with higher percentage of acid reflux events compared to supra-upper esophageal sphincter reflux events.
  • Supra-upper esophageal sphincter reflux events were associated with greater proportion of non-acid reflux events.
  • Fifty-four percent of reflux events documented by pH-impedance were associated with symptoms. More than 87 percent of the pH-only events were associated with symptoms.
  • Symptomatic acid reflux events were associated with longer acid clearance time.
  • Prolonged acidity was associated with symptomatic acid reflux events in chronic lung disease patients.

"It is clear from this study that symptoms can occur with acid, non-acid, gas, liquid or mixed events," said Dr. Jadcherla. "So, treatment strategies based on modifying gastric acidity alone can be ineffective as acid is not the lone provoking agent."

Dr. Jadcherla says it is also clear why the management of GERD based on symptoms only is controversial, as there are reflux-type symptoms in the absence of reflux.

"Overall, this study helps clarify the definition of GERD: gastroesophageal reflux with increased frequency of respiratory, sensory or movement symptoms," said Dr. Jadcherla.


Story Source:

The above story is based on materials provided by Nationwide Children's Hospital. Note: Materials may be edited for content and length.


Journal Reference:

  1. Sudarshan R. Jadcherla, Juan Peng, Chin Yee Chan, Rebecca Moore, Lai Wei, Soledad Fernandez, Carlo Di Lorenzo. Significance of Gastroesophageal Refluxate in Relation to Physical, Chemical, and Spatiotemporal Characteristics in Symptomatic Intensive Care Unit Neonates. Pediatric Research, 2011; 70 (2): 192 DOI: 10.1203/PDR.0b013e31821f704d

Cite This Page:

Nationwide Children's Hospital. "New study helps clarify symptoms and characteristics of acid reflux in neonates." ScienceDaily. ScienceDaily, 8 August 2011. <www.sciencedaily.com/releases/2011/08/110808115410.htm>.
Nationwide Children's Hospital. (2011, August 8). New study helps clarify symptoms and characteristics of acid reflux in neonates. ScienceDaily. Retrieved October 26, 2014 from www.sciencedaily.com/releases/2011/08/110808115410.htm
Nationwide Children's Hospital. "New study helps clarify symptoms and characteristics of acid reflux in neonates." ScienceDaily. www.sciencedaily.com/releases/2011/08/110808115410.htm (accessed October 26, 2014).

Share This



More Health & Medicine News

Sunday, October 26, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

Texas Nurse Nina Pham Cured of Ebola

Texas Nurse Nina Pham Cured of Ebola

AFP (Oct. 25, 2014) — An American nurse who contracted Ebola while caring for a Liberian patient in Texas has been declared free of the virus and will leave the hospital. Duration: 01:01 Video provided by AFP
Powered by NewsLook.com
Toxin-Packed Stem Cells Used To Kill Cancer

Toxin-Packed Stem Cells Used To Kill Cancer

Newsy (Oct. 25, 2014) — A Harvard University Research Team created genetically engineered stem cells that are able to kill cancer cells, while leaving other cells unharmed. Video provided by Newsy
Powered by NewsLook.com
IKEA Desk Converts From Standing to Sitting With One Button

IKEA Desk Converts From Standing to Sitting With One Button

Buzz60 (Oct. 24, 2014) — IKEA is out with a new convertible desk that can convert from a sitting desk to a standing one with just the push of a button. Jen Markham explains. Video provided by Buzz60
Powered by NewsLook.com
Ebola Protective Suits Being Made in China

Ebola Protective Suits Being Made in China

AFP (Oct. 24, 2014) — A factory in China is busy making Ebola protective suits for healthcare workers and others fighting the spread of the virus. Duration: 00:38 Video provided by AFP
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
 
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:  

Breaking News:

Strange & Offbeat Stories

 

Health & Medicine

Mind & Brain

Living & Well

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News



Save/Print:
Share:  

Free Subscriptions


Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile


Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?


Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile iPhone Android Web
Follow Facebook Twitter Google+
Subscribe RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins