ESPGHAN-NASPGHAN Guidelines for the Evaluation and Treatment of Gastrointestinal and Nutritional Complications in Children With Esophageal Atresia-Tracheoesophageal Fistula
Journal of Pediatric Gastroenterology and Nutrition
Krishnan, U., Mousa, H., et al. (2016).
Journal of Pediatric Gastroenterology and Nutrition, 63(5), 550-570.
This clinical practice guideline provides recommendations for the evaluation and treatment of children with esophageal atresia. The guideline group members used the nominal voting technique. Expert opinion was used when no randomized controlled trials were available to support the recommendation. Although this guideline is intended for physicians involved with this population, some recommendations are pertinent to the speech-language pathologist's scope of practice.
European Society for Pediatric Gastroenterology, Hepatology, and Nutrition; North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition
Symptoms of aspiration can be identical to gastroesophageal reflux symptoms in young children. "Diagnostic testing includes modified barium swallow (videofluoroscopic swallow studies) or fiber optic endoscopic evaluation of swallowing" (Expert Opinion; Low evidence; p. 557).
Dysphagia should be suspected in individuals with esophageal atresia who present with the following symptoms:
<ul>
<li>food aversion;</li>
<li>difficult or painful swallowing;</li>
<li>choking;</li>
<li>coughing;</li>
<li>pneumonia;</li>
<li>altered eating habits;</li>
<li>vomiting; and</li>
<li>malnutrition (Expert Opinion; Low evidence).</li>
</ul>
Treatment options to manage post-fundoplication dysphagia in patients with esophageal atresia may include but are not limited to the following:
<ul>
<li>feeding adaptation; and</li>
<li>gastrostomy tube feeding (Expert Opinion; Very Low evidence).</li>
</ul>
Treatment options to treat dysphagia in patients with esophageal atresia may include but are not limited to the following:
<ul>
<li>feeding adaptation; and</li>
<li>gastrostomy tube feeding (Expert Opinion; Low evidence). </li>
</ul>
