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IDENTIFICATION OF UNDERLYING CAUSES OF CHRONIC UNSPECIFIC UPPER GASTROINTESTINAL-RELATED SYMPTOMS IN CHILDREN, A
Insights
Chronic upper gastrointestinal (GIT) symptoms in children often indicate motility disorders like GERD, with H. pylori infection being highly prevalent. Upper endoscopy is crucial for diagnosing these conditions in pediatric patients.
Area of Science:
- Pediatric Gastroenterology
- Gastrointestinal Motility Disorders
- Helicobacter pylori Infection
Background:
- Non-specific upper gastrointestinal tract (GIT) symptoms in children present diagnostic challenges.
- Differentiating various GIT disorders based solely on symptoms is often difficult.
Purpose of the Study:
- To investigate the underlying causes of chronic, non-specific upper GIT symptoms in pediatric patients.
- To evaluate the diagnostic utility of upper endoscopy in this population.
Main Methods:
- A prospective study involving 30 Egyptian children with chronic upper GIT symptoms (duration ≥ 2 months).
- Detailed symptom history collection, excluding cases with known explanatory disorders.
- Upper gastrointestinal endoscopy with biopsies for histopathological examination and H. pylori testing.
Main Results:
- The study included children aged 2.5–18 years (mean 13.6 ± 3.4), with 63.3% females. Primary complaints included epigastric pain (43.3%), hematemesis (30%), and vomiting (26.7%).
- Motility disorders were diagnosed in 66.7%, primarily gastroesophageal reflux disease (GERD) (63.3%). Erosive esophagitis was noted in 15.8% of GERD cases; Barrett's esophagus was absent.
- Helicobacter pylori infection was confirmed histologically in 80% of patients. Eosinophilic esophagitis was not detected.
Conclusions:
- Motility disorders, particularly GERD, are frequent causes of chronic upper GIT symptoms in children.
- High prevalence of H. pylori infection warrants consideration in the etiological workup.
- Upper endoscopy remains a valuable diagnostic tool for identifying the causes of persistent upper GIT symptoms in children.
Abstract:
Upper gastrointestinal tract (GIT) symptoms are not disease specific and of limited value in the differentiation of GIT disorders. The present study aimed to determine the etiology of chronic unspecific symptoms in children and to test the need for upper endoscopy in diagnosis. This is a prospective study for 30 Egyptian children presented with chronic upper GIT symptoms for at least 2 months. History regarding severity and frequency of GIT symptoms were asked for. Children with known disorder that explains presenting symptoms were excluded. Upper GIT endoscopy wa performed and 5 biopsies were obtained for pathological examination and for Hpylori testing. The results showed that children age ranged between 2.5-18 years with mean ± SD of 13.6 ± 3.4 and 63.3% were females. The main complaints were epigastric pain in 43.3%, hematemesis in 30% and vomiting in 26.7%. Motility disorders were diagnosed in 66.7% children; in the form of GERD in 63.3% and achalasia in one. Complication of GERD in the form of erosive esophagitis was present in 15.8% children, while Barrett's esophagus was not observed. H. pylori infection was diagnosed in 80% histologically. Eosinophilic esophagitis was not detected.
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