Pediatric gastroesophageal motility disorders Diagnosis and management

Gastroesophageal motility disorders are caused by disruptions in esophageal peristalsis or abnormal upper and lower esophageal sphincter function. Part 1 of this thesis focuses on the diagnostic tests (High Resolution Manometry and pH-impedance) used to evaluate gastroesophageal motility disorders. We evaluated the burden patients experience from these function tests and the effect of sleeping positions on nocturnal reflux disease. Part 2 discusses esophageal atresia, an esophageal birth defect which can cause a large number of gastroesophageal symptoms. We evaluate the feasibility of gastric function tests and High Resolution Manometry in this patient group. Additionally, the usefulness of routinely performed pH-impedance and gastroscopies is evaluated. The 3rd part of this thesis discusses diagnostics and treatment of pediatric achalasia. We also present our protocol for a multicenter randomized controlled trial that evaluating initial treatment options in pediatric achalasia.