Characterization of Esophageal and Sphincter Reflexes across Maturation in Dysphagic Infants with Oral Feeding Success vs Infants requiring Gastrostomy.
Nancy Swiader, Kathryn A Hasenstab, Vedat O Yildiz and 1 others
PMID 33576892WHAT IT FOUND
Infants discharged on oral feeds showed normal maturation of swallowing reflexes.
Those requiring gastrostomy tubes did not, showing persistent lack of improvement in esophageal motility and sphincter reflexes, which may explain why they continue to struggle with oral feeding.
Key findings
01Control infants showed significant maturational improvements in esophageal and sphincter reflexes, including increased upper and lower esophageal sphincter tone and more frequent effective swallow responses.
02Infants requiring gastrostomy tubes showed minimal differences between pre- and post-placement evaluations, with no significant improvement in peristaltic or sphincter reflexes other than increased upper esophageal sphincter resting pressure.
03At the second evaluation, infants with gastrostomy tubes had distinct manometric profiles compared to controls, including longer upper esophageal sphincter relaxation duration and higher likelihood of secondary peristalsis.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
Read the rest of this summary
You get three full summaries a month, free, and we do not ask for a card. Search, the TL;DRs and your library stay unlimited either way.
What it does not show
The study had a very small sample size (29 infants total). The population was heterogeneous, with many infants in the study group having underlying neuropathology, which independently affects swallowing mechanics. It was a retrospective design, meaning data was not collected prospectively for this specific comparison. The timing of gastrostomy placement and the interval between the two manometry tests varied among participants. The study used water-perfusion manometry, which is less advanced than current high-resolution manometry standards.
Declared interests
The authors declare no conflicts of interest. The work was supported by the National Institutes of Health (NIH).
The easy way to misread this
Do not interpret the lack of reflex maturation in the gastrostomy group as solely caused by the tube itself. The study notes that these infants had higher rates of underlying neuropathology and chronic feeding issues, which likely contributed to the poor motility outcomes independent of the gastrostomy placement.