Lower esophageal sphincter dysfunction in esophageal atresia: nocturnal regurgitation and aspiration pneumonia.

The association between lower esophageal sphincter (LES) incompetence, gastroesophageal reflux, and recurrent pneumonia in patients who have undergone successful repair of esophageal atresia (EA) and tracheoesophageal fistula is demonstrated in this study. The efficacy of esophageal manometric examination in the evaluation of the LES in young children after EA repair is documented. This study also provides evidence that infants and children with LES incompetence associated with EA may have LES responsiveness to bethanechol. Once established by manometry, this responsiveness may be used to manage the patient until surgical repair would be advantageous.