Please enter verification code
Current Approaches to the Treatment of Gastroesophageal Reflux Disease in Children with Neurology
American Journal of Pediatrics
Volume 5, Issue 1, March 2019, Pages: 14-17
Received: Jan. 10, 2019; Accepted: Feb. 14, 2019; Published: Mar. 5, 2019
Views 796      Downloads 114
Nurlan Nurkinovich Akhparov, Department of Surgery, Scientific Center of Pediatrics and Pediatric Surgery, Almaty, Republic of Kazakhstan
Riza Zulkarnaevna Boranbayeva, Department of Pediatrics, Scientific Center of Pediatrics and Pediatric Surgery, Almaty, Republic of Kazakhstan
Saule Bakhtyarovna Suleimanova, Pediatric Surgery Chair, Medical University Astana, Astana, Republic of Kazakhstan
Vasiliy Mikhailovich Lozovoy, Pediatric Surgery Chair, Medical University Astana, Astana, Republic of Kazakhstan
Article Tools
Follow on us
The incidence of gastroesophageal reflux in children with neurological disorders is more common than in the rest of the pediatric population. The risk of reflux development in these children is due to abnormal motility of the gastrointestinal tract, their long term staying in bed (a horizontal position), a disruption of the swallowing process, a delayed evacuation of food from the esophagus and stomach, and a weakened muscle tone that pose a serious threat to a patient by possible complications (such as reflux esophagitis, peptic stricture, erosion and bleeding), and sometimes being one of the causes of death. From 2008 to 2018, 128 patients with gastroesophageal reflux disease were hospitalized in the Department of Surgery of the Scientific Center for Pediatrics and Pediatric Surgery including 33 (26%) children with neurological disorders, of which 28 (85%) were operated. All of the patients underwent Nissen esophagofundoplications, of which in 21 (75%) children it was combined with Stamm gastrostomy and in 18 (64%) children with Mikulich pyloroplasty. The results of surgical treatment were analysed in all the 28 patients in the early period (7-14 days) after surgery. In 2 (7%) children who did not undergo the pyloroplasty there was a complication in the form of gastric distress syndrome, which required an additional surgery in order to drain the stomach. A relapse of gastroesophageal reflux disease was observed in 1 (4%) patient who was re-operated. In the remaining 25 (89%) children, the postoperative period was favourable. Their gastrostomy tube feeding was carried out according to the age requirements. The long-term results were studied in time interval from 6 months to 3 years after surgery. X-ray control examination, fibroendoscopy and 24-hour pH monitoring were conducted in all children in the distant period. The results of the treatment are favourable, the weight deficit is filled, the reflux esophagitis is stopped and the reflux-associated inflammations of the bronchopulmonary system are reduced. To a large extent, the choice of operational tactics can be adapted to the condition of a particular child, the results of objective and instrumental tests for GERD, the pseudobulbar disorders and associated pyloric functional disorders. Timely correction of reflux disorders in children with pathologies of the central nervous system helps prevent the development of serious complications, which will inevitably improve a child’s quality of life.
Gastroesophageal Reflux, Neurology, Children
To cite this article
Nurlan Nurkinovich Akhparov, Riza Zulkarnaevna Boranbayeva, Saule Bakhtyarovna Suleimanova, Vasiliy Mikhailovich Lozovoy, Current Approaches to the Treatment of Gastroesophageal Reflux Disease in Children with Neurology, American Journal of Pediatrics. Vol. 5, No. 1, 2019, pp. 14-17. doi: 10.11648/j.ajp.20190501.13
Copyright © 2019 Authors retain the copyright of this article.
This article is an open access article distributed under the Creative Commons Attribution License ( which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Gossler A., Schalamon J., Huber-Zeyringer A. et al. Gastroesophageal reflux and behavior in neurologically impaired children. J Pediatr Surg., 2007, vol. 42. – Р. 1486-90.
Morton R. E., Wheatley R., Minford J. Respiratory tract infections due to direct and reflux aspiration in with severe neurodisability. Dev. Med. Child. Neurol. 1999; 41: 329-34.
Pensabene L., Miele E., Giudice E. D. et al. Mechanisms of gastroesophageal reflux in children with sequelae of birth asphyxia // Brain Dev. — 2008. — Vol. 30. — Р. 563-71.
Miele E., Staiano A., Tozzi A. et al. Clinical response to aminoacid-based formula in neurologically impaired children with refractory esophagitis // J Pediatr Gastroenterol Nutr. — 2002. — Vol. 35. — Р. 314-9.
Vandenplas Y., Rudolph C. D., Di Lorenzo C. et al. Pediatric Gastroesophageal Reflux Clinical Practice Guidelines: Joint Recommendations of the North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition (NASPGHAN) and the European Society for Pediatric Gastroenterology, Hepatology, and Nutrition (ESPGHAN) // Journal of Pediatric Gastroenterology and Nutrition. — 2009. — Vol. 49. — Р. 498-547.
Hassall E., Kerr W., El-Sera HB. Characteristics of children receiving proton pump inhibitors continuously for up to 11 years duration // J Pediatr. — 2007. — Vol. 150. — Р. 262.
Hassall, E. Decisions in diagnosing and managing chronic gastroesophageal reflux disease in children/ E. Hassall // J. Pediatr. – 2005. – Vol. 146, № 1. – P. 3-12.
Guimaraes, E. Treatment of gastroesophageal reflux disease / E. Guimaraes, C. Marguet, P. Camargos // J. Pediatr. – 2006. – Vol. 82, № 5. – P. 133-145.
Razumovsky, A. Yu. Laparoscopic fundoplication - a radical method of treating gastroesophageal reflux in children / A. Yu. Razumovsky, A. B. Alkhasov, V. E. Rachkov // Pediatrics. - 2006. - № 5. - Р. 57.
Lobe, T. The current role of laparoscopic surgery for gastroesophageal reflux disease in infants and children / T. Lobe // Surg. Endosc. – 2007. – Vol. 21, № 2. – P. 167-174.
Kane, T. D. Position paper on laparoscopic antireflux operations in infants and children for gastroesophageal reflux disease. American Pediatric Surgery Association / T. D. Kane, M. F. Brown, M. K. Chen // J. Pediatr. Surg. – 2009. – Vol. 44, № 5. – P. 1034-1040.
Tovar, A. J. Pediatric surgeons and gastroesophageal reflux / A. J. Tovar, L. A. Luis, L. J. Encinas // J. Pediatr. Surg. – 2007. – Vol. 42. – P. 277-283.
Fonkalsrub, E. W. Antireflux surgery in children under 3 months of age / E. W. Fonkalsrub, J. Bustorff-Silva, C. A. Perez // J. Pediatr. Surg. – 1999. – Vol. 34, № 4. – P. 527-531.
Berezin, S. Gastroesophageal reflux secondary to gastrostomy tube placement / S. Berezin, S. M. Schwarz, M. S. Halata // Am. J. Dis. Child. – 1986. – Vol. 140, № 7. – P. 699-701.
Lasser M. S., Liao J. G., Burb R. S. National trends in the use of antireflux procedures for children. Pediatrics. 2006; 118: 1828-35.
Science Publishing Group
1 Rockefeller Plaza,
10th and 11th Floors,
New York, NY 10020
Tel: (001)347-983-5186