Evaluation of Pepsin (A) By Mouth Swab as A Diagnostic Marker In Preterm Neonates With Clinical Gastro Oesophageal Reflux

Abstract

astro esophageal reflux (GER) is common during infancy, especially in preterm infants. The increased risk of GERD in preterm infants is thought to be due to immature or impaired anatomic and physiologic factors. Most infants have no complications from their GER and do not require further evaluation or intervention because GER usually resolves without intervention by one year of age. GER disease (GERD) is defined as GER that causes morbidity. Signs or symptoms that are often attributed to GER include irritability, nonspecific behaviors suggesting discomfort such as posturing or grimacing, frequent bouts of emesis, worsening of lung disease, and failure to thrive. However, it is likely that in many cases GERD is not the underlying cause of these symptoms. In addition, GERD is probably not a common trigger or mechanism for pathologic apnea of prematurity, although in selected cases a causal relationship may exist. The diagnosis of GERD is challenging in preterm infants because symptoms are nonspecific, and diagnostic testing (esophageal pH and multiple intraluminal impedance monitoring) is limited due to technical problems and difficulties of interpreting results in the newborn. Moreover, esophageal monitoring rarely establishes a causal association between GER and pathologic consequences.