GASTROESOPHAGEAL REFLUX AND CHRONIC RESPIRATORY-DISEASE IN INFANTS AND CHILDREN - SURGICAL-TREATMENT

Background: Many infants have chronic respiratory symptoms related to gastro-oesophageal reflux. The reflux seems to be due to a motility disorder, possibly because of an immature neuro-hormonal system. Most infants outgrow the disorder. Infants and children with severe symptoms and poor response to medical treatment may benefit from operation. Nissen fundoplication is the most commonly used procedure. In some children it is necessary to add a pyloroplasty to the fundoplication because of slow gastric emptying. Methods: From May 1991 to March 1993 eight children with severe gastro-oesophageal reflux disease were operated on using the Nissen fundoplication procedure. Results: Seven to 29 months after the operation all children are much better. Conclusions: Children who do not respond to 6 weeks with aggressive medical treatment should be referred to surgery.