Pediatric gastroesophageal motility disorders Diagnostic possibilities and pitfalls

Esophageal motility disorders are common in the pediatric population, but are often difficult to diagnose and treat. Infants and children can exhibit both congenital and developmental gastrointestinal motility disorders and many adult disorders may emerge in childhood. In this thesis, the most common upper gastrointestinal motility disorders in infants and children are described. Part I of this thesis comprises studies of the epidemiology and prognosis of pediatric gastroesophageal reflux disease. It also describes the application of several (novel) diagnostic tools for the diagnosis of gastroesophageal reflux disease in infants. And finally, the use of combined pH-impedance and manometry measurement for the diagnosis of rumination syndrome in children is discussed. Part II includes studies on the pathophysiology and diagnosis of other esophageal motility disorders and achalasia in particular. Novel and conventional measurements of esophageal function are explored to gain more insight into the (patho)physiology of pediatric esophageal motility disorders and to improve their diagnosis, with the objective to achieve earlier detection and provide better-targeted treatment options.