Hayat Mousa1,2, Usha Krishnan3,4, Maheen Hassan5,6, Luigi Dall'Oglio7, Rachel Rosen8,9, Frédéric Gottrand10, Christophe Faure11,12. 1. Division of Pediatric Gastroenterology, Neurogastroenterology and Motility Center, Pediatric Gastroenterology, Hepatology, and Nutrition, Rady Children's Hospital, 3020 Children's Way, MC 5030, San Diego, CA, 92123, USA. hmousa@ucsd.edu. 2. San Diego (UCSD) School of Medicine, University of California, San Diego, CA, USA. hmousa@ucsd.edu. 3. Department of Pediatric Gastroenterology, Sydney Children's Hospital, Sydney, Australia. 4. Discipline of Pediatrics, School of Women's and Children's Health, University of New South Wales, Sydney, Australia. 5. Division of Pediatric Gastroenterology, Neurogastroenterology and Motility Center, Pediatric Gastroenterology, Hepatology, and Nutrition, Rady Children's Hospital, 3020 Children's Way, MC 5030, San Diego, CA, 92123, USA. 6. San Diego (UCSD) School of Medicine, University of California, San Diego, CA, USA. 7. Digestive Endoscopy and Surgery Unit, Bambino Gesu Children's Hospital-IRCCS, Rome, Italy. 8. Aerodigestive Digestive Centre, Division of Gastroenterology and Nutrition, Boston Children's Hospital, Boston, MA, USA. 9. Harvard Medical School, Harvard, MA, USA. 10. Department of Pediatric Gastroenterology Hepatology and Nutrition, CHU Lille, Univ. Lille, National Reference Center for Congenital Malformation of the Esophagus, F-59000, Lille, France. 11. Division of Pediatric Gastroenterology, Sainte-Justine Hospital, Montreal, QC, Canada. 12. Department of Pediatrics, Université de Montréal, Montreal, QC, Canada.
Abstract
PURPOSE OF REVIEW: Guidelines were recently published highlighting why esophageal atresia (EA) patients are prone to complication risks, and the need for long-term follow-up. In this review, we will focus on how to investigate and treat potential complications, as well as the pros and cons of different investigative and treatment modalities, and what areas continue to need further research. RECENT FINDINGS: EA patients are at high risk for gastroesophageal reflux and esophageal strictures, and the sequela that result. Extraintestinal manifestations of gastroesophageal reflux disease (GERD) can appear similar to other pathologic diagnoses commonly found in EA patients, such as congenital stricture, eosinophilic esophagitis, esophageal dysmotility, tracheomalacia, recurrent fistula, aspiration, etc. Therefore, it is important to have a standardized way to monitor for these issues. pH impedance allows for detection of nonacid reflux and the height of reflux, which are important in correlating symptoms with reflux episodes. A multidisciplinary approach is beneficial in evaluating and monitoring EA patients in the long term.
PURPOSE OF REVIEW: Guidelines were recently published highlighting why esophageal atresia (EA) patients are prone to complication risks, and the need for long-term follow-up. In this review, we will focus on how to investigate and treat potential complications, as well as the pros and cons of different investigative and treatment modalities, and what areas continue to need further research. RECENT FINDINGS: EA patients are at high risk for gastroesophageal reflux and esophageal strictures, and the sequela that result. Extraintestinal manifestations of gastroesophageal reflux disease (GERD) can appear similar to other pathologic diagnoses commonly found in EA patients, such as congenital stricture, eosinophilic esophagitis, esophageal dysmotility, tracheomalacia, recurrent fistula, aspiration, etc. Therefore, it is important to have a standardized way to monitor for these issues. pH impedance allows for detection of nonacid reflux and the height of reflux, which are important in correlating symptoms with reflux episodes. A multidisciplinary approach is beneficial in evaluating and monitoring EA patients in the long term.
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