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Reflux oesophagitis in children; the role of endoscopy. A multicentric Italian survey

G Lombardi1, G de' Angelis, V Rutigliano

  • 1Paediatric Gastroenterology Unit, Spirito Santo Hospital, Via Fonte Romana 8, 65100 Pescara, Italy. dolomb@tin.it

Digestive and Liver Disease : Official Journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver
|August 8, 2007
PubMed

Insights

Histology, not just visual endoscopy, improves diagnosis accuracy for pediatric reflux esophagitis. Biopsies are crucial for accurate grading and guiding treatment decisions in children.

Area of Science:

  • Pediatric Gastroenterology
  • Gastrointestinal Endoscopy
  • Histopathology

Background:

  • Diagnosing reflux esophagitis in children is challenging due to non-specific symptoms.
  • Endoscopic visual findings may not always correlate with the actual severity of esophagitis.

Purpose of the Study:

  • To determine the diagnostic value of endoscopy and histology for reflux esophagitis in children.
  • To analyze the relationship between symptoms, endoscopic findings, and histology in pediatric gastroesophageal reflux disease.

Main Methods:

  • 136 children (aged 1-18) with suspected reflux esophagitis were studied.
  • Symptom, endoscopic, and histologic scores were assessed before and after proton pump inhibitor therapy.

Main Results:

  • A strong correlation existed between symptoms and endoscopic scores pre-therapy, but not histologic scores.
  • Histologic grade frequently exceeded endoscopic visual assessment.
  • Both endoscopic and histologic scores improved significantly after therapy.

Conclusions:

  • Esophageal biopsies significantly enhance the diagnostic accuracy of upper endoscopy.
  • Histologic grading is often more critical than endoscopic appearance for diagnosing esophagitis.
  • Clinical symptom evaluation should precede endoscopic examination for optimal diagnosis.
Abstract

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