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Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Jul 28, 2015; 21(28): 8508-8515
Published online Jul 28, 2015. doi: 10.3748/wjg.v21.i28.8508
Gastroesophageal reflux and congenital gastrointestinal malformations
Lucia Marseglia, Sara Manti, Gabriella D’Angelo, Eloisa Gitto, Carmelo Salpietro, Antonio Centorrino, Gianfranco Scalfari, Giuseppe Santoro, Pietro Impellizzeri, Carmelo Romeo
Lucia Marseglia, Gabriella D’Angelo, Eloisa Gitto, Neonatal Intensive Care Unit, Department of Pediatrics, University of Messina, 98125 Messina, Italy
Sara Manti, Carmelo Salpietro, Unit of Paediatric Genetics and Immunology, Department of Paediatrics, University of Messina, 98125 Messina, Italy
Antonio Centorrino, Gianfranco Scalfari, Pietro Impellizzeri, Carmelo Romeo, Unit of Pediatric Surgery, Department of Pediatrics, University of Messina, 98125 Messina, Italy
Giuseppe Santoro, Department of Biomedical Sciences and Morpho-Functional Images, University of Messina, 98125 Messina, Italy
Author contributions: Marseglia L coordinated the initial draft of this publication; Manti S, D’Angelo G, Gitto E and Salpietro C wrote the paper; Centorrino A, Scalfari G and Santoro G prepared the final draft; Impellizzeri P and Romeo C approved the final version.
Conflict-of-interest statement: The authors declare no conflicts of interest.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Lucia Marseglia, MD, Neonatal Intensive Care Unit, Department of Pediatrics, University of Messina, Via Consolare Valeria, 1, 98125 Messina, Italy. lmarseglia@unime.it
Telephone: +39-90-2213100 Fax: +39-90-2213876
Received: January 21, 2015
Peer-review started: January 22, 2015
First decision: March 26, 2015
Revised: April 24, 2015
Accepted: May 27, 2015
Article in press: May 27, 2015
Published online: July 28, 2015
Processing time: 189 Days and 18.2 Hours
Abstract

Although the outcome of newborns with surgical congenital diseases (e.g., diaphragmatic hernia; esophageal atresia; omphalocele; gastroschisis) has improved rapidly with recent advances in perinatal intensive care and surgery, infant survivors often require intensive treatment after birth, have prolonged hospitalizations, and, after discharge, may have long-term sequelae including gastro-intestinal comorbidities, above all, gastroesophageal reflux (GER). This condition involves the involuntary retrograde passage of gastric contents into the esophagus, with or without regurgitation or vomiting. It is a well-recognized condition, typical of infants, with an incidence of 85%, which usually resolves after physiological maturation of the lower esophageal sphincter and lengthening of the intra-abdominal esophagus, in the first few months after birth. Although the exact cause of abnormal esophageal function in congenital defects is not clearly understood, it has been hypothesized that common (increased intra-abdominal pressure after closure of the abdominal defect) and/or specific (e.g., motility disturbance of the upper gastrointestinal tract, damage of esophageal peristaltic pump) pathological mechanisms may play a role in the etiology of GER in patients with birth defects. Improvement of knowledge could positively impact the long-term prognosis of patients with surgical congenital diseases. The present manuscript provides a literature review focused on pathological and clinical characteristics of GER in patients who have undergone surgical treatment for congenital abdominal malformations.

Keywords: Gastroesophageal reflux; Congenital diaphragmatic hernia; Esophageal atresia; Omphalocele; Gastroschisis

Core tip: Although the outcome of newborns with surgical congenital diseases has improved rapidly with recent advances in perinatal intensive care and surgery, infant survivors often may have long-term sequelae including, above all, gastroesophageal reflux (GER). Common or specific pathological mechanisms may play a role in the etiology of GER in patients with birth defects. The improvement of knowledge of long-term outcome and follow-up could positively impact the long-term prognosis of newborns with surgical congenital diseases. The present manuscript provides a literature review focused on pathological and clinical characteristics of GER in patients who have undergone surgical treatment for congenital abdominal malformations.