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Pathophysiology of gastroesophageal reflux in neurologically impaired children

Research Project

Project/Area Number 26462706
Research Category

Grant-in-Aid for Scientific Research (C)

Allocation TypeMulti-year Fund
Section一般
Research Field Pediatric surgery
Research InstitutionHamamatsu University School of Medicine

Principal Investigator

Kawahara Hisayoshi  浜松医科大学, 医学部附属病院, 特任准教授 (20224826)

Project Period (FY) 2014-04-01 – 2018-03-31
Project Status Completed (Fiscal Year 2017)
Budget Amount *help
¥4,940,000 (Direct Cost: ¥3,800,000、Indirect Cost: ¥1,140,000)
Fiscal Year 2016: ¥1,560,000 (Direct Cost: ¥1,200,000、Indirect Cost: ¥360,000)
Fiscal Year 2015: ¥1,430,000 (Direct Cost: ¥1,100,000、Indirect Cost: ¥330,000)
Fiscal Year 2014: ¥1,950,000 (Direct Cost: ¥1,500,000、Indirect Cost: ¥450,000)
Keywords胃食道逆流 / GER / 胃排出遅延 / 食道インピーダンスpHモニタリング / 酸性GER / 非酸性GER / 重症心身障がい児 / 食道インピーダンスpHモニタリング / 胃食道逆流症 / 酸性胃食道逆流 / 非酸性胃食道逆流 / 食道インピーダンスpHモニタリグ / 胃排出能 / 六君子湯 / 胃瘻 / 噴門形成術 / gastroesophageal reflux / impedance pH monitoring / gastric emptying / rikkunshito / gastrostomy / neurological impairment
Outline of Final Research Achievements

Neurologically impaired(NI) patients showed a wide range of gastric emptying rates without any significant causal relationship between delayed gastric emptying and gastroesophageal reflux(GER). The results suggest that the proximal gastric accommodation, which is caused by adaptive gastric relaxation, is a more important factor for controlling GER than the acceleration of gastric emptying.
There was an increase in acid GER in NI pediatric patients with abnormal GER, whereas acid and nonacid GER were comparable in NI pediatric patients without abnormal GER. Although the underlying mechanism of our findings could not be fully explained, physiologically appropriate therapeutic approaches for GER disease in NI patents should include the reduction of acid GER to that of nonacid GER rather than the complete prevention of all GER.

Report

(5 results)
  • 2017 Annual Research Report   Final Research Report ( PDF )
  • 2016 Research-status Report
  • 2015 Research-status Report
  • 2014 Research-status Report
  • Research Products

    (32 results)

All 2017 2016 2015 2014 Other

All Journal Article (17 results) (of which Peer Reviewed: 13 results,  Acknowledgement Compliant: 4 results,  Open Access: 3 results) Presentation (14 results) (of which Invited: 2 results) Remarks (1 results)

  • [Journal Article] Characteristics of gastroesophageal reflux in pediatric patients with neurological impairment.2017

    • Author(s)
      Kawahara H, Tazuke Y, Soh H, Usui N, Okuyama H
    • Journal Title

      Pediatric Surgery International

      Volume: 33 Issue: 10 Pages: 1073-1079

    • DOI

      10.1007/s00383-017-4139-7

    • Related Report
      2017 Annual Research Report
  • [Journal Article] 小児 24 時間食道インピーダンスpHモニタリングプロトコール2017

    • Author(s)
      川原央好、深堀 優、田中彩、尾山貴徳、羽鳥麗子、齋藤 武、藤野順子、野田卓男、下野隆一、八木実
    • Journal Title

      日本小児外科学会雑誌

      Volume: 53 Pages: 1215-1219

    • NAID

      130006177810

    • Related Report
      2017 Annual Research Report
  • [Journal Article] 食道インピーダンスpHモニタリング検査の有用性2016

    • Author(s)
      川原央好
    • Journal Title

      週刊日本医事新報

      Volume: 4827 Pages: 61-63

    • Related Report
      2016 Research-status Report
  • [Journal Article] Causal relationship between delayed gastric emptying and gastroesophageal reflux in patients with neurological impairment2015

    • Author(s)
      Kawahara H, Tazuke Y, Soh H, Usui N, Fukuzawa M
    • Journal Title

      Pediatric Surgery International

      Volume: 31 Issue: 10 Pages: 917-923

    • DOI

      10.1007/s00383-015-3769-x

    • Related Report
      2015 Research-status Report
    • Peer Reviewed / Acknowledgement Compliant
  • [Journal Article] Cardiac fetal ultrasonographic parameters for predicting outcomes of isolated left-sided congenital diaphragmatic hernia2015

    • Author(s)
      Yamoto M, Tanaka Y, Fukumoto K, Miyake H, Nakajima H, Koyama M, Mitsushita N, Nii M, Kawahara H, Urushihara N
    • Journal Title

      Journal of Pediatric Surgery

      Volume: 50 Issue: 12 Pages: 2019-2024

    • DOI

      10.1016/j.jpedsurg.2015.08.016

    • Related Report
      2015 Research-status Report
    • Peer Reviewed / Acknowledgement Compliant
  • [Journal Article] Long-term outcomes of four patients with tracheal agenesis who underwent airway and esophageal reconstruction.2015

    • Author(s)
      Tazuke Y, Okuyama H, Uehara S, Ueno T, Nara K, Yamanaka H, Kawahara H, Kubota A, Usui N, Soh H, Nomura M, Oue T, Sasaki T, Nose S, Saka R
    • Journal Title

      Journal of Pediatric Surgery

      Volume: 50 Issue: 12 Pages: 2009-2011

    • DOI

      10.1016/j.jpedsurg.2015.08.014

    • Related Report
      2015 Research-status Report
    • Peer Reviewed
  • [Journal Article] Megacystis microcolon intestinal hypoperistalsis syndrome: A report of a nationwide survey in Japan2015

    • Author(s)
      Soh H, Fukuzawa M, Kubota A, Kawahara H, Ueno T, Taguchi T
    • Journal Title

      Journal of Pediatric Surgery

      Volume: 50 Issue: 12 Pages: 2048-2050

    • DOI

      10.1016/j.jpedsurg.2015.08.026

    • Related Report
      2015 Research-status Report
    • Peer Reviewed
  • [Journal Article] Parental Nutrition-Associated Liver Disease in Extremely Low Birth Weight Infants with Intestinal Disease.2015

    • Author(s)
      Hirano K, Kubota A, Nakayama M, Kawahara H, Yoneda A, Tazuke Y, Tani G, Ishii T, Goda T, Umeda S, Hirno S, Shiraishi J, Kitajima H.
    • Journal Title

      Pediatr Int.

      Volume: 57 Issue: 4 Pages: 677-81

    • DOI

      10.1111/ped.12609

    • Related Report
      2015 Research-status Report
    • Peer Reviewed / Open Access / Acknowledgement Compliant
  • [Journal Article] Long-term alpha-tocopherol supplements may improve mental development in extremely low birthweight infants.2015

    • Author(s)
      Kitajima H, Kanazawa T, Mori R, Hirano S, Ogihara T, Fujimura M.
    • Journal Title

      Acta Paediatr.

      Volume: 104 Issue: 1 Pages: 82-9

    • DOI

      10.1111/ped.12409

    • Related Report
      2015 Research-status Report
    • Peer Reviewed / Open Access / Acknowledgement Compliant
  • [Journal Article] Efficacy and safety of strong acid electrolyzed water for peritoneal lavage to prevent surgical site infection in patients with perforated appendicitis2015

    • Author(s)
      Kubota A, Goda T, Tsuru T, Yonekura T, Yagi M, Kawahara H, Yoneda A, Tazuke Y, Tani G, Ishii T, Umeda S, Hirano K
    • Journal Title

      Surgery Today

      Volume: 45 Issue: 7 Pages: 876-879

    • DOI

      10.1007/s00595-014-1050-x

    • Related Report
      2015 Research-status Report
    • Peer Reviewed
  • [Journal Article] Physiological analysis of the effects of rikkunshito on acid and non-acid gastroesophageal reflux using pH-multichannel intraluminal impedance monitoring.2014

    • Author(s)
      Kawahara H, Tazuke Y, Soh H, Yoneda A, Fukuzawa M.
    • Journal Title

      Pediatric Surgery International

      Volume: 30 Issue: 9 Pages: 927-931

    • DOI

      10.1007/s00383-014-3565-z

    • Related Report
      2014 Research-status Report
    • Peer Reviewed
  • [Journal Article] Does laparoscopy-aided gastrostomy placement improve or worsen gastroesophageal reflux in patients with neurological impairment?2014

    • Author(s)
      Kawahara H, Tazuke Y, Soh H, Yoneda A, Fukuzawa M.
    • Journal Title

      Journal of Pediatric Surgery

      Volume: 49 Issue: 12 Pages: 1742-1745

    • DOI

      10.1016/j.jpedsurg.2014.09.008

    • Related Report
      2014 Research-status Report
    • Peer Reviewed
  • [Journal Article] Selenium deficiency in children and adolescents nourished by parenteral nutrition and/or selenium-deficient enteral formula.2014

    • Author(s)
      Etani Y, Nishimoto Y, Kawamoto K, Yamada H, Shouji Y, Kawahara H, Ida S.
    • Journal Title

      Journal of trace elements in medicine and biology

      Volume: 28 Issue: 4 Pages: 409-413

    • DOI

      10.1016/j.jtemb.2014.09.001

    • Related Report
      2014 Research-status Report
    • Peer Reviewed
  • [Journal Article] Efficacy of the circulatory management of an antenatally diagnosed congenital diaphragmatic hernia: outcomes of the proposed strategy.2014

    • Author(s)
      Inamura N, Kubota A, Ishii R, Ishii Y, Kawazu Y, Hamamichi Y, Yoneda A, Kawahara H, Okuyama H, Kayatani F.
    • Journal Title

      Pediatric Surgery International

      Volume: 30 Issue: 9 Pages: 889-894

    • DOI

      10.1007/s00383-014-3574-y

    • Related Report
      2014 Research-status Report
    • Peer Reviewed
  • [Journal Article] Pediatric chronic intestinal pseudo-obstruction is a rare, serious, and intractable disease: A report of a nationwide survey in Japan.2014

    • Author(s)
      Muto M, Matsufuji H, Tomomasa T, Nakajima A, Kawahara H, Ida S, Ushijima K, Kubota A, Mushiake S, Taguchi T.
    • Journal Title

      J Pediatr Surg

      Volume: 49(12) Issue: 12 Pages: 1799-1803

    • DOI

      10.1016/j.jpedsurg.2014.09.025

    • Related Report
      2014 Research-status Report
    • Peer Reviewed / Open Access
  • [Journal Article] Esophago-gastric motility and nutritional management in a child with ATR-X syndrome.2014

    • Author(s)
      Watanabe T, Arai K, Takahashi M, Ohno M, Sato K, Fuchimoto Y, Wada T, Ida S, Kawahara H, Kanamori Y.
    • Journal Title

      Pediatrics International

      Volume: 56 Issue: 4

    • DOI

      10.1111/ped.12402

    • Related Report
      2014 Research-status Report
    • Peer Reviewed
  • [Journal Article] 硫酸アトロピン療法(静注)2014

    • Author(s)
      川原央好、田附裕子、曺英樹、米田光宏、山田寛之、庄司保子、惠谷ゆり、位田忍、福澤正洋.
    • Journal Title

      小児外科

      Volume: 46 Pages: 1029-1032

    • Related Report
      2014 Research-status Report
  • [Presentation] 食道インピーダンスpHモニタリングによる小児胃食道逆流評価試案2017

    • Author(s)
      川原央好
    • Organizer
      第47回日本小児消化管機能研究会
    • Place of Presentation
      九州大学医学部百年講堂
    • Year and Date
      2017-02-11
    • Related Report
      2016 Research-status Report
  • [Presentation] Characteristics of gastroesophageal reflux in pediatric patients with neurological impairment2017

    • Author(s)
      Hisayoshi Kawahara
    • Organizer
      14th OESO World Conference Global Perspective in Esophageal Diseases
    • Related Report
      2017 Annual Research Report
  • [Presentation] 食道インピーダンスpHモニタリングによる重症心身障がい児における胃食道逆流の病態の解明2017

    • Author(s)
      川原 央好,田附 裕子,曺 英樹,臼井 規朗、奥山 宏臣
    • Organizer
      第54回日本小児外科学会学術集会
    • Related Report
      2017 Annual Research Report
  • [Presentation] 食道インピーダンスpHモニタリング(MII-pH)による小児胃食道逆流(GER)評価試案2017

    • Author(s)
      川原央好 深掘 優 尾山貴徳 野田卓男 齋藤 武 田中 彩  羽鳥麗子 藤野順子 下野隆一 八木 実
    • Organizer
      第54回日本小児外科学会学術集会
    • Related Report
      2017 Annual Research Report
  • [Presentation] 重症心身障がい児のGERDに 対する包括的治療戦略2017

    • Author(s)
      川原央好
    • Organizer
      第79回日本臨床外科学会総会
    • Related Report
      2017 Annual Research Report
  • [Presentation] 私の勧める漢方治療:GERD2017

    • Author(s)
      川原央好
    • Organizer
      第22回日本小児外科漢方研究会
    • Related Report
      2017 Annual Research Report
  • [Presentation] 重症心身障がい児に対する噴門形成術の是非を問う是か?非か? 非2016

    • Author(s)
      川原央好
    • Organizer
      第116回日本外科学会定期学術集会
    • Place of Presentation
      大阪国際会議場
    • Year and Date
      2016-04-16
    • Related Report
      2016 Research-status Report
  • [Presentation] 重症心身障がい児に対する噴門形成術の是非を問う是か?非か?2016

    • Author(s)
      川原央好
    • Organizer
      第106回日本外科学会学術集会
    • Place of Presentation
      大阪
    • Year and Date
      2016-04-16
    • Related Report
      2015 Research-status Report
    • Invited
  • [Presentation] 食道インピーダンスpHモニタリングでわかること2016

    • Author(s)
      川原央好
    • Organizer
      第46回日本小児消化管機能研究会
    • Place of Presentation
      倉敷
    • Year and Date
      2016-02-13
    • Related Report
      2015 Research-status Report
    • Invited
  • [Presentation] 胃瘻栄養中の重症心身障がい児のQOLの向上をめざした漢方薬治療の経験 ーさらなる、QOL向上を目指してー2015

    • Author(s)
      川原 央好, 松本 真理子, 小倉 薫
    • Organizer
      第26回日本小児外科QOL研究会
    • Place of Presentation
      山梨
    • Year and Date
      2015-10-17
    • Related Report
      2015 Research-status Report
  • [Presentation] 重症心身障がい児者における胃食道逆流の病態における胃排出遅延の意義2015

    • Author(s)
      川原央好、小倉薫、田附裕子、曺英樹、臼井規朗、福澤正洋
    • Organizer
      第52回日本小児外科学会学術集会
    • Place of Presentation
      神戸
    • Year and Date
      2015-05-30
    • Related Report
      2015 Research-status Report
  • [Presentation] 胃食道逆流の病因としての胃排出遅延の意義 についての検討2014

    • Author(s)
      川原央好
    • Organizer
      第7回J-FD研究会
    • Place of Presentation
      東京
    • Year and Date
      2014-11-08
    • Related Report
      2014 Research-status Report
  • [Presentation] Does laparoscopy-aided gastrostomy placement improve or worsen gastroesophageal reflux in patients with neurological impairment?2014

    • Author(s)
      Kawahara H, Tazuke Y, Soh H, Yoneda A, Fukuzawa M
    • Organizer
      PAPS(Pacific Association of Pediatric Surgeons) 2014
    • Place of Presentation
      Banff, Canada
    • Year and Date
      2014-05-26
    • Related Report
      2014 Research-status Report
  • [Presentation] インピーダンスpHモニタリングを用いた六君子湯の胃食道逆流に対する生理学的効果の検討2014

    • Author(s)
      川原央好 田附裕子 曹 英樹 米田光宏 福澤正洋
    • Organizer
      第51回日本小児外科学会学術集会
    • Place of Presentation
      大阪
    • Year and Date
      2014-05-10
    • Related Report
      2014 Research-status Report
  • [Remarks] 臨床栄養のリスクマネジメントに必要な漢方薬のエビデンス

    • URL

      http://www.kampo-s.jp/web_magazine/back_number/261/index2-261.htm

    • Related Report
      2015 Research-status Report

URL: 

Published: 2014-04-04   Modified: 2019-03-29  

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