Esophageal dysmotility in children breast-fed by mothers with silicone breast implants. Long-term follow-up and response to treatment

Dig Dis Sci. 1996 Aug;41(8):1600-3. doi: 10.1007/BF02087907.

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.

MeSH terms

  • Biopterin / analogs & derivatives
  • Biopterin / urine
  • Breast Feeding*
  • Breast Implants / adverse effects*
  • Child
  • Child, Preschool
  • Esophageal Motility Disorders / drug therapy
  • Esophageal Motility Disorders / etiology*
  • Esophageal Motility Disorders / physiopathology
  • Esophageal Motility Disorders / urine
  • Esophagogastric Junction / physiopathology
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Manometry
  • Metoclopramide / pharmacology
  • Neopterin
  • Nitrates / urine
  • Pressure
  • Silicones / adverse effects*

Substances

  • Nitrates
  • Silicones
  • Biopterin
  • Neopterin
  • Metoclopramide