Summary
Background: Disordered oesophageal and gastric motility may pose serious problems in affected children.
Methods: Review of literature.
Results: In premature infants, suction, swallowing and respiration may not be fully coordinated, which permits a penetration of food into the nasopharynx and aspiration. Oropharyngeal dysphagia occurs with central nervous disorders, tongue and pharyngeal muscle weakness, malformations and incomplete pharyngo-oesophageal sphincter relaxation upon swallowing. Oesophageal obstruction may result from impaired inhibitory innervation. In children with atresy, the motility of the remaining oesophagus is most often compromised. Achalasia of the gastro-oesophageal sphincter results from a lack of nitric-oxide synthase in the myenteric plexus. Diffuse oesophageal spasms may occur “spontaneously” or upon gastro-oesophageal refluxes. Reflux is fostered by transient, non-swallow-induced relaxations and a low gastro-oesophageal sphincter resting pressure; oesophageal clearance of refluate often is impaired. Pathological reflux diminishes during the first year of life but is frequent in children with respiratory diseases, apnoeas, mental retardation and cerebral palsy. Gastric emptying may be slow in preterm infants, gastro-oesophageal reflux disease and a variety of other conditions. Hypertrophic pyloric stenosis results from a lack of nitric-oxide synthesis in the myenteric plexus.
Conclusions: Oesophageal and gastric motility disorders should receive due attention. Their adequate treatment relies on appropriate diagnostic measures.