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[Our experience in the subject of gastroesophageal reflux disease]

L Maestri1, F Mari, P Elli

  • 1Divisione di Chirurgia Pediatrica - Ospedale dei Bambini - Milano.

Insights

Early diagnosis of gastroesophageal reflux (GER) in children is crucial for preventing complications. Infants with GER and severe esophageal pH monitoring showed milder esophagitis compared to older children.

Area of Science:

  • Pediatric Gastroenterology
  • Gastrointestinal Motility Disorders
  • Esophageal Pathophysiology

Background:

  • Gastroesophageal reflux (GER) is common in children, potentially leading to serious complications.
  • Diagnostic challenges exist in assessing GER severity and predicting outcomes.
  • Understanding age-related differences in GER complications is essential for effective management.

Purpose of the Study:

  • To evaluate the diagnostic utility of barium esophagogram, esophageal pH monitoring, and esophagoscopy in pediatric GER.
  • To assess the effectiveness of medical therapy versus surgical intervention for GER in children.
  • To investigate the relationship between age, diagnostic findings, and complication severity in pediatric GER.

Main Methods:

  • Retrospective analysis of 66 children diagnosed with GER between 1983 and 1988.
  • Utilized barium esophagogram, esophageal pH monitoring, and esophagoscopy for diagnosis.
  • Documented medical therapy (n=49) and surgical interventions (n=13) and their outcomes.

Main Results:

  • Medical therapy led to clinical improvement in 46 out of 49 children.
  • Older children experienced more severe complications associated with GER.
  • Infants with GER and abnormal esophageal pH monitoring showed only mild (I-II grade) esophagitis.

Conclusions:

  • Early and accurate diagnosis of GER in children is vital to prevent severe complications.
  • Age is a significant factor influencing GER complication severity.
  • Diagnostic tools like esophageal pH monitoring can help stratify risk and guide treatment decisions in pediatric GER.

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