Achalasia previously diagnosed as gastroesophageal reflux disease by relying on esophageal impedance-pH monitoring: Use of high-resolution esophageal manometry in children

Jung Eun Pyun, Da Min Choi, Jung Hwa Lee, Kee Hwan Yoo, Jung Ok Shim

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Gastroesophageal reflux disorder (GERD) is the most common esophageal disorder in children. Achalasia occurs less commonly but has similar symptoms to GERD. A nine-year old boy presented with vomiting, heartburn, and nocturnal cough. The esophageal impedance-pH monitor revealed nonacidic GERD (all-refluxate clearance percent time of 20.9%). His symptoms persisted despite medical treatment for GERD, and he was lost to follow up. Four years later, he presented with heartburn, solid-food dysphagia, daily post-prandial vomiting, and failure to thrive. Endoscopy showed a severely dilated esophagus with candidiasis. High-resolution manometry was performed, and he was diagnosed with classic achalasia (also known as type I). His symptoms resolved after two pneumatic dilatation procedures, and his weight and height began to catch up to his peers. Clinicians might consider using high-resolution manometry in children with atypical GERD even after evaluation with an impedance-pH monitor.

Original languageEnglish
Pages (from-to)55-59
Number of pages5
JournalPediatric Gastroenterology, Hepatology and Nutrition
Volume18
Issue number1
DOIs
Publication statusPublished - 2015 Jan 1

Keywords

  • Child
  • Electric impedance
  • Esophageal achalasia
  • Esophageal pH monitoring
  • Gastroesophageal reflux
  • Manometry

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Hepatology
  • Gastroenterology

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