Manometric diagnosis of lower esophageal sphincter incompetence in infants: use of a small, single-lumen perfused catheter.

Lower esophageal sphincter (LES) pressure is frequently measured to diagnose LES incompetence in adults. The multilumen perfused catheters with large diameters that are used for ths purpose are not suitable for small infants. We measured LES pressure in ten normal newborns with a small, single-lumen perfused catheter and compared our values with those obtained with the standard adult apparatus. Higher pressures were recorded with the single-lumen catheter. Chloral hydrate sedation had no effect on LES pressure. Two-day-old infants had LES pressures comparable to those of adults and older children. The technique was applied to the diagnosis of LES incompetence in 23 infants. Infants with LES incompetence (chalasia) were correctly separated from infants with chronic vomiting secondary to all other causes. Single-lumen manometric studies provide a simple, reliable, and safe method of assessing LES incompetence in small infants.