Dysphagia in children: a paediatric surgical perspective.

Dysphagia in childhood encompasses all disorders of swallowing. The patient groups seen frequently in paediatric surgical practice are those with repaired oesophageal atresia, some patients with gastro-oesophageal reflux disease and those with neurological impairment. Oesophageal atresia patients frequently experience dysphagia that is most troublesome in early childhood, fortunately for most the long-term outlook is good. Gastro-oesophageal reflux may give rise to dysphagia as a result of peptic structure, dysmotility associated with oesophagitis or as a complication of anti-reflux surgery. Children with neurological impairment and swallowing problems are very difficult for their carers to manage. Gastrostomy represents a pragmatic solution to their nutritional needs.