Scintigraphic assessment of gastroesophageal reflux in wheezing babies
Keywords:
wheezing baby syndrome, gastroesophageal reflux, radionuclide ImagingAbstract
Objective
Evaluate the role of scintigraphy in the assessment of post-prandial gastro-esophageal reflux in wheezing babies.
Methods
Thirteen wheezing babies with post-prandial gastroesophageal reflux (10 males and 3 females; mean age 1 1 months; mean weight 1 1.6kg) were studied (Group 1 ). Patients were treated with 0.2mg/kg of cisapride, 3 times a day during 4 to 8 diagnosed by medical history, physical examination, and scÉntigraphy. Twelve wheezing babies with physiologic post-prandiaf gastroesophageal reflux (6 males and 6 femaIes; mean age 8.7 months; mean weight 10.7kg) were included as a comparative group (Group 2), Patients were submitted to scintigraphies using 18,5 MBq of 99“'Tc-sulfur colloid. Post-prandial gastroesophageal reflux episodes were evaluated according to the esophageal regions. The total duration time of post-prandial gastroesophageal reflux episodes was recorded (seconds). Postprandial gastroesophageal reflux was considered physiologic when the total duration time of post-prandial gastroesophageal reflux episodes was lower than 8 seconds and limited to the distal esophagus. The patients were submitted to two scintigraphies: a baseline scintigraphy, performed before cisapride therapy and a follow-up scintigraphy, performed after cisapride therapy.
Results
There was a statistically significant reduction in the total duration time of postprandial gastroesophageal reflux episodes in the upper and middle esophageal regions in the follow-up scintigraphy studies compared to baseline scintigraphy' There was a also a reduction in the total duration time of post-prandial gastroesophageal reflux episodes in the distal esophageal regions in the followup scintigraphy studies when compared to baseline scintigraphy, however, this reduction was not statistically significant. The total duration tIme of post-prandial gastroesophageal reflux episodes in the distal esophageal region was significantly higher in Group 1 as compared to Group 2.
Conclusion
Scintigraphy is a non-invasive, easy to perform method for determining the reduction of post-prandial gastroesophageal reflux in wheezing babies. This method, due to the low radiation dose, can be performed repeatedly, in order to attain a proper evaluation of post-prandial gastroesophageal reflux.
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