Structurally, EA patients, particularly those with long gap EA, can also lose some function of the anti-reflux barrier after surgical repair. In addition, there is abnormal development of the esophageal smooth muscle, with distorted smooth muscle tissue and tracheobronchial remnants found in the esophagus. This results in impaired peristalsis and lower esophageal sphincter function. They have abnormal in utero development of the myenteric plexus of the esophagus, with decreased or absent interstitial cells of Cajal. Finally, we will focus on the long-term consequences of EA in adulthood and on the importance of the follow-up of adult patients with EA.ĮA patients are at increased risk for gastroesophageal reflux due both to intrinsic dysmotility and to structural factors.
#Gerd endoscopy findings how to
In this article, we will review in greater detail how to investigate and treat the gastrointestinal complications associated with EA.
The most recently published consensus guidelines, reviewed literature and gathered experts’ opinions on the epidemiology of EA and its natural history, and made recommendation on the management of gastrointestinal complications in this cohort. The most common problems patients with EA are at risk for include: gastroesophageal reflux disease (GERD) with or without esophagitis, Barrett’s esophagus (BE), dysphagia, strictures, eosinophilic esophagitis, feeding and nutritional problems, recurrent respiratory tract infections, persistent cough, and wheezing. This increased survival prompts a need to focus on long-term complications. With improvements in surgical and perioperative care, survival rates now exceed 90%. Esophageal atresia (EA) is a congenital anomaly with an incidence ranging from 1 in 2,400 to 1 in 4,500 births worldwide.
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