Investigations people with EA may require, and follow-up

It’s often advisable to have a team of doctors following someone with EA. For children, the team may include a pediatric gastroenterologist (“stomach specialist”), a pediatric surgeon, a pediatric respirologist (“lung specialist”) and/or a pediatrician. For adults, the team may include a gastroenterologist, a surgeon, a respirologist and/or an internist. EA is a rare condition, and many specialists (particularly adult specialists) may not be very familiar with this condition, and its potential complications.

In people with EA who have respiratory symptoms such as persistent cough, wheezing, shortness of breath, sputum production, and/or recurrent episodes of bronchitis or pneumonia, it’s important to rule out tracheomalacia and aspiration, before assuming that the symptom(s) are due to conventional asthma. Tests that may be helpful in this situation can include:

• Bronchoscopy
• Upper endoscopy
• Upper GI series
• Esophageal pH and/or impedance study
• “TEF Study”
• Nuclear gastric (milk) scan
• Esophageal manometry

As the risk of Barret’s Esophagus and esophageal cancer appears to be increased in adults with EA, many experts are now recommending regular upper endoscopies throughout adulthood.

Tom Kovesi MD, Pediatric Respirologist, Children’s Hospital of Eastern Ontario, Ottawa, Ontario Canada
06/10/2013

Bibliography:

• Ebook Frontiers Update on EA-TEF Octobre 2017
  Usha Krishnan 1,2* and Christophe Faure 3,4
  1 Department of Pediatric Gastroenterology, Sydney Children’s Hospital, Sydney, NSW, Australia,
  2 Discipline of Pediatrics, School of Women’s and Children’s Health, University of New South Wales, Sydney, NSW, Australia,
  3 Division of Pediatric Gastroenterology, Sainte-Justine Hospital, Montreal, QC, Canada,
  4 Department of Pediatrics, Université de Montréal, Montreal, QC, Canada
  
• Long-term respiratory complications of congenital esophageal atresia with or without tracheoesophageal fistula: an update. May 2013
  Dis Esophagus. 2013 May-Jun;26(4):413-6.
  Kovesi T 5
  5 Department of Pediatrics, Children’s Hospital of Eastern Ontario, University of Ottawa, 401 Smyth Rd, Ottawa, ON, Canada. kovesi@cheo.on.c
• Long-term results of esophageal atresia: Helsinki experience and review of literature.
  Pediatr Surg Int. 2011 Nov;27(11):1141-9.
  Sistonen SJ 1, Pakarinen MP, Rintala RJ
  1 Department of Paediatric Surgery, University of Helsinki, Helsinki, Finland. saara.sistonen@hus.fi

Esophageal Atresia Global Support Groups e.V. Sommerrainstrasse 61, 70374 Stuttgart, Germany