Abstract
Esophageal dysmotility is almost universal after esophageal atresia (EA) repair and is mainly related to the developmental anomaly of the esophagus. Esophageal dysmotility is involved in the pathophysiology of numerous symptoms and comorbidities associated with EA such as gastroesophageal reflux disease, aspiration and respiratory complications, and symptoms of dysphagia and feeding disorders. High-resolution esophageal manometry (HREM) has facilitated the characterization of the dysmotility, but there is an incomplete correlation between symptoms and manometrical patterns. Impedance coupled to HREM should help to predict the clinical outcome and therefore personalize patient management. Nowadays, the management of esophageal dysmotility in patients with EA is essentially based on treatment of associated inflammation related to peptic or eosinophilic esophagitis.
Highlights
Esophageal dysmotility is involved in the pathophysiology of numerous symptoms and comorbidities associated with esophageal atresia (EA) such as gastroesophageal reflux disease, aspiration and respiratory complications, and symptoms of dysphagia and feeding disorders
High-resolution esophageal manometry (HREM) has facilitated the characterization of the dysmotility, but there is an incomplete correlation between symptoms and manometrical patterns
Impedance coupled to HREM should help to predict the clinical outcome and personalize patient management
Summary
In patients operated for EA, abnormal motility of the esophagus remains the key pathophysiological catalyst leading to digestive and respiratory morbidity throughout life. Esophageal motility is involved in the process of transporting food from the mouth to the stomach and plays a central role in the defense of the esophagus against gastric reflux. A well-organized swallowing process, from the mouth to the esophagus guarantees an adequate protection of the respiratory tract against aspiration. The following section highlights the consequences of the impaired esophageal motility in patients with EA
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