A pediatric patient with cerebral palsy and a gastric feeding tube is evaluated for fundoplication. This procedure is used to treat which condition?

• A. Gastroesophageal reflux
• B. Oral/motor dysfunction
• C. Malnutrition
• D. Esophagitis

Answer: (A)

Fundoplication is an anti-reflux surgery designed to treat gastroesophageal reflux by strengthening the barrier at the lower esophageal junction. In children with cerebral palsy who have a feeding tube, reflux often persists and can lead to aspiration and feeding intolerance. Wrapping part of the stomach around the distal esophagus creates a tighter barrier to reflux and reduces both the frequency and volume of reflux episodes, helping improve feeding tolerance and decrease reflux-related symptoms and complications such as esophagitis. While oral/motor dysfunction and malnutrition are concerns in this population, the procedure specifically targets the reflux problem itself, and reducing reflux can indirectly aid nutrition. Esophagitis is a consequence of reflux that may improve with this intervention, but the primary purpose is to treat gastroesophageal reflux.