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Prevalence of endoscopic findings of erosive esophagitis in children: a population-based study

Mark A Gilger1, Hashem B El-Serag, Benjamin D Gold

  • 1Department of Pediatrics, Baylor College of Medicine, Houston Center for Quality of Care & Utilization Studies, Veterans Administration Hospital, Houston, TX, USA. mgilger@bcm.edu

Journal of Pediatric Gastroenterology and Nutrition
|July 31, 2008
PubMed

Insights

Erosive esophagitis affects 12.4% of children undergoing endoscopy, with prevalence increasing with age. Hiatal hernia is the only endoscopic finding that predicts erosive esophagitis in pediatric patients.

Area of Science:

  • Pediatric Gastroenterology
  • Gastrointestinal Endoscopy
  • Reflux Disease Research

Background:

  • Gastroesophageal reflux disease (GERD) affects 2-7% of children, with varied manifestations.
  • Complications like erosive esophagitis, strictures, and Barrett esophagus can occur.
  • The prevalence of GERD complications in children remains largely unknown.

Purpose of the Study:

  • To determine the prevalence of erosive esophagitis in children.
  • To analyze endoscopic findings associated with erosive esophagitis in pediatric patients.

Main Methods:

  • Retrospective analysis of 7188 children (ages 0-17) undergoing upper endoscopy (1999-2002).
  • Inclusion criteria: complete endoscopic reports with demographics, indications, and findings.
  • Erosive esophagitis defined descriptively or by Los Angeles classification; esophageal biopsy excluded.

Main Results:

  • 12.4% (888/7188) of children had erosive esophagitis.
  • Prevalence increased with age, from 5.5% in infants to 19.6% by age 17.
  • Hiatal hernia was significantly more common in children with erosive esophagitis (7.7% vs 2.5%).
  • Male children showed a higher prevalence of erosive esophagitis (55.2% vs 48.2%).

Conclusions:

  • Erosive esophagitis prevalence in children increases with age and is slightly higher in males.
  • Unlike adults, no significant racial or ethnic variations were observed.
  • Hiatal hernia is the sole endoscopic predictor of erosive esophagitis in this pediatric cohort.
Abstract

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