How to Care for Patients with EA-TEF: The Known and the Unknown

Curr Gastroenterol Rep. 2017 Nov 25;19(12):65. doi: 10.1007/s11894-017-0605-6.

Abstract

Purpose of review: Guidelines were recently published highlighting why esophageal atresia (EA) patients are prone to complication risks, and the need for long-term follow-up. In this review, we will focus on how to investigate and treat potential complications, as well as the pros and cons of different investigative and treatment modalities, and what areas continue to need further research.

Recent findings: EA patients are at high risk for gastroesophageal reflux and esophageal strictures, and the sequela that result. Extraintestinal manifestations of gastroesophageal reflux disease (GERD) can appear similar to other pathologic diagnoses commonly found in EA patients, such as congenital stricture, eosinophilic esophagitis, esophageal dysmotility, tracheomalacia, recurrent fistula, aspiration, etc. Therefore, it is important to have a standardized way to monitor for these issues. pH impedance allows for detection of nonacid reflux and the height of reflux, which are important in correlating symptoms with reflux episodes. A multidisciplinary approach is beneficial in evaluating and monitoring EA patients in the long term.

Keywords: Anastamotic strictures; Complications; Eosinophilic esophagitis; Esophageal atresia; Gastroesophageal reflux disease; Long-term follow-up; Multichannel intraluminal impedance; Review; Tracheoesophageal fistula.

Publication types

  • Review

MeSH terms

  • Antacids / therapeutic use
  • Eosinophilic Esophagitis / diagnosis
  • Eosinophilic Esophagitis / etiology
  • Esophageal Atresia / complications*
  • Esophageal Atresia / diagnosis
  • Esophageal Stenosis / etiology
  • Esophageal Stenosis / prevention & control
  • Esophageal pH Monitoring / methods
  • Gastroesophageal Reflux / diagnosis
  • Gastroesophageal Reflux / etiology*
  • Humans
  • Long-Term Care / methods*
  • Tracheoesophageal Fistula / complications*
  • Tracheoesophageal Fistula / diagnosis

Substances

  • Antacids

Supplementary concepts

  • Esophageal atresia with or without tracheoesophageal fistula