Diagnosis and Management of Long-term Gastrointestinal Complications in Pediatric Esophageal Atresia/Tracheoesophageal Fistula

Abstract

Purpose of review: Esophageal atresia/tracheoesophageal fistula (EA/TEF) causes gastrointestinal (GI) complications that can begin in infancy and extend into adulthood. The etiology of these is frequently multifactorial, and they can adversely affect feeding, growth, respiratory health, and overall quality of life. This review highlights the importance of early diagnosis, multidisciplinary surveillance, and individualized treatment strategies to effectively manage these complications and improve long-term outcomes for affected children.

Recent findings: Recent studies have focused on the development of evidence-based surveillance protocols to optimally manage the numerous observed EA/TEF-associated digestive complications. Many of these complications stem from the combination of gastroesophageal dysmotility and mechanical obstruction inherent to EA/TEF and its surgical management, and include gastroesophageal reflux disease, feeding difficulties, dysphagia, eosinophilic esophagitis, and pulmonary consequences of aspiration. Management of GI complications in children with EA/TEF requires careful, multidisciplinary evaluation and treatment, incorporating dietary modifications, feeding therapy, pharmacotherapy, and surgical and endoscopic interventions.

Keywords: Dysphagia, eosinophilic esophagitis; Esophageal Stricture; Esophageal atresia/tracheoesophageal fistula; Esophageal dysmotility; Feeding difficulties; Gastroesophageal reflux disease.