Esophageal dysmotility in children breast-fed by mothers with silicone breast implants

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Unique Identifier 8769286

Authors Levine JJ. Trachtman H. Gold DM. Pettei MJ.

Institution Division of Gastroenterology and

Nutrition, Schneider Children's Hospital, Albert

Einstein College of Medicine, New Hyde Park, New York

11040, USA.

Title:

Esophageal dysmotility in children breast-fed by

mothers with silicone breast implants.

Long-term follow-up and response to treatment.

Source Digestive Diseases & Sciences. 41(8):1600-3,

1996 Aug.

Abstract

Our aims were to determine the long-term clinical and

manometric follow-up of 11 children with previously

documented esophageal dysmotility, who had been

breast-fed by mothers with silicone breast implants,

their response to prokinetic agents, and to analyze

changes in macrophage activation. Seven of 11 children

had subjective clinical improvement. Weight/ height

ratios remained the same or improved in 9/11. Biopsies

at follow-up endoscopy were either normal or

demonstrated mild esophagitis in 8/10. LES and UES

pressures and percent propagation were not

significantly different at follow-up, while wave

amplitude significantly increased. Following

intravenous metoclopramide, LES pressure, percent

propagation, and wave amplitude significantly

increased while UES pressure was unchanged. Urinary

neopterin significantly decreased at follow-up, while

urinary nitrates were unchanged. Esophageal

dysmotility is chronic in this group of children,

suggesting persistent autonomic nervous system

dysfunction. Prokinetic agents may be useful in

long-term management. The decreasing urinary neopterin

levels suggest that, ultimately, there may be

improvement in esophageal motility.

Publication Type Journal Article.