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• W3024993301 abstract "To the Editor: We thank Fishbein and Daniak for their interest in our recent publication regarding air-swallows and GERD-like symptoms (1). To address their suspicion that the 2 infants in our study had aerophagia with feeds, we re-examined the impedance-pH tracings and found that both infants were indeed aerophagic during feeding; air-swallow rates were 10.9 per hour and 13.7 per hour for the infant boy and infant girl, respectively. When considering air-swallows and symptoms during feeding periods only, air-swallows were significantly associated with cough (SAP = 96.9%, P = 0.0369) for the infant girl, and with back-arching (SAP = 96.3%, P = 0.0366) for the infant boy. The study by Fishbein et al (2) suggesting a relationship between GERD-like symptoms and aerophagia in a subset of infants is interesting and we agree with the recommendation that infants with GERD-like symptoms receive a careful evaluation of feeding history and referral to speech-language pathologist when aerophagia is suspected, particularly in the absence of GER-symptom association(s) during impedance-pH testing. At our facility, when patients present with symptoms suggestive of GER, we generally will assess those patients for pathologic reflux using impedance-pH monitoring (the gold standard) and when/if GERD is ruled out, alternative diagnoses are considered. We are particularly excited about our novel use of the impedance-pH technology that permits simultaneous and objective evaluation of putative relationships between GER and symptoms and/or between air-swallows and symptoms (1). The standard bedside swallow evaluation that is described (2) is interesting and would be a valuable addition, particularly given that approximately 1 in 4 infants (23.9%) with GERD-like symptoms have oropharyngeal dysphagia (2). Both studies suggest a relationship between air-swallows and GERD-like symptoms in some infants and similarly underscore the importance of considering non-GER diagnoses when managing GERD-like symptoms in infants. Additional, multicenter studies involving larger samples sizes are needed to further study this relationship." @default.
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• W3024993301 date "2020-05-12" @default.
• W3024993301 modified "2023-09-26" @default.
• W3024993301 title "Air-swallow/GERD-like Symptom Associations Assessed Using a Novel Application of Esophageal Impedance Technology" @default.
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• W3024993301 doi "https://doi.org/10.1097/mpg.0000000000002775" @default.
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