What is the role of gastric capacity in pediatric gastroesophageal reflux disease (GERD)?

Updated: Mar 14, 2019
  • Author: Steven M Schwarz, MD, FAAP, FACN, AGAF; Chief Editor: Carmen Cuffari, MD  more...
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Answer

The volume ratio of meal-stomach-esophagus differs between adults and infants. Necessary amounts of infant caloric requirements easily overwhelm gastric capacity. Reflux occurs when esophageal capacity is exceeded by refluxate.

Decreased gastric compliance is believed to lead to LES relaxation at lower intragastric volumes in infants. This aspect, in conjunction with abdominal wall muscle contraction (if it occurs during periods of LES relaxation) propels refluxate into the esophagus, with subsequent regurgitation.

An association between gastroesophageal reflux and delayed gastric emptying is recognized. This is more common in premature infants.


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