Neonatal gastroesophageal reflux assessment: Infant GER questionnaire revised and ultrasound evaluation of lungs, abdominal esophagus with gastric emptying time estimation
Abstract
Gastroesophageal reflux disease (GERD) is common in neonates, but diagnosis is difficult due to nonspecific symptoms and limitations of invasive tools. There is a need for safe, bedside diagnostic methods.
To evaluate an integrated, non-invasive model combining lung ultrasound (LUS), abdominal esophageal length, gastric emptying time, and the Infant Gastroesophageal Reflux Questionnaire-Revised (I-GERQ-R) in diagnosing and monitoring neonatal GERD.
This prospective case-control study included 60 neonates: 30 with symptomatic GERD and 30 healthy controls. Clinical data, feeding history, and anthropometric measurements were obtained. Ultrasound assessed esophageal length, gastric emptying, and post-feeding lung changes. I-GERQ-R scores were recorded before and after treatment.
GERD infants compared to controls had significantly shorter esophageal length (17.2 ± 1.5 vs. 22.9 ± 1.5 mm; p < 0.001), delayed gastric emptying (132 ± 14.9 vs. 78 ± 14.9 min; p < 0.001), and reduced feeding volume relative to weight (38.6 ± 15.2 vs. 66.2 ± 13.5 ml; p < 0.001). Post-feeding LUS scores were higher in cases (0–3 scale) (p < 0.001). After treatment, GERD infants showed improved gastric emptying, feeding tolerance, LUS findings, and lower IGERQ-R scores (17.1 ± 2.9 to 16.2 ± 2.6; p = 0.001). Esophageal length negatively correlated with post-treatment I-GERQ-R scores (r = −0.514, p = 0.004).
Integrating clinical scoring with ultrasound of the esophagus, stomach, and lungs provides a…
How strong is the evidence?
Evidence Hub reads this as a case-control, done in people. Its evidence level is 4 of 5 (Low · observational). Observational designs can show an association but not prove cause.
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