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Correlation between esophageal pH-metry and esophagitis in gastroesophageal reflux disease in children
Vasile Valeriu Lupu1, Marin Burlea, Nicolai Nistor
1Pediatrics Department Preventive Medicine Department, University of Medicine and Pharmacy "Grigore T. Popa" Clinic of Pulmonary Disease Medical Informatics and Biostatistics Department, University of Medicine and Pharmacy "Gr. T. Popa", Iasi, Romania.
Insights
Gastroesophageal reflux disease (GERD) diagnosis in children using 24-hour pH-metry shows a strong correlation with esophagitis severity found during endoscopy. pH-metry scores can accurately predict GERD and esophagitis grade in pediatric patients.
Area of Science:
- Pediatric Gastroenterology
- Diagnostic Medicine
- Gastrointestinal Disorders
Background:
- Gastroesophageal reflux (GER) involves stomach content moving into the esophagus.
- Gastroesophageal reflux disease (GERD) is diagnosed when reflux causes symptoms or complications.
- Accurate diagnosis of GERD in children is crucial for effective management.
Purpose of the Study:
- To compare the diagnostic accuracy of 24-hour esophageal pH-metry with upper digestive endoscopy findings in pediatric GERD patients.
- To evaluate the correlation between pH-metry scores (Boix-Ochoa score) and the degree of esophagitis in children with GERD.
Main Methods:
- A study involving 72 children over 4 years old diagnosed with GERD via 24-hour pH-metry (positive Boix-Ochoa score).
- All participants underwent upper digestive endoscopy to assess esophagitis.
- Statistical analysis, including ANOVA, was used to compare pH-metry scores and esophagitis grades.
Main Results:
- All 72 children diagnosed with GERD showed esophagitis on endoscopy (47 with Grade A, 25 with Grade B).
- A statistically significant higher Boix-Ochoa score was observed in GERD patients with Grade B esophagitis compared to Grade A.
- A strong positive correlation was found between pH-metry scores and endoscopic findings, indicating high diagnostic concordance.
Conclusions:
- 24-hour esophageal pH-metry is a reliable method for diagnosing GERD and assessing esophagitis severity in children.
- Upper digestive endoscopy may be reserved for pediatric GERD cases unresponsive to treatment or with complications.
- The findings suggest pH-metry alone can be sufficient for diagnosing GERD and its associated esophagitis grade in pediatric populations.
Abstract:
Gastroesophageal reflux (GER) is the intermittent or permanent passage of stomach content into the esophagus and gastroesophageal reflux disease (GERD) is the reflux which triggers a whole set of symptoms or complications. The study compares the 24-hours esophageal pH-metry, used for diagnosis of the GERD, with the esophagitis degree observed at the upper digestive endoscopy.72 children were included, aged over 4 years old, admitted in a pediatric gastroenterology regional center in Northeast Romania, diagnosed with GERD by 24 hours pH-metry (with a positive Boix-Ochoa score), which also underwent the upper digestive endoscopy.Out of the 72 children diagnosed with GERD, 47 (65.28%) had grade A esophagitis and 25 (34.72%) grade B esophagitis. In GERD associated with grade B esophagitis the Boix-Ochoa score is statistically significant higher, compared with the GERD associated with grade A esophagitis (F = 9.76, P = .0036, 95% CI).Upper digestive endoscopy performed in patients with gastroesophageal reflux disease shows the constant presence of esophagitis at all patients. There were only grade A and B esophagitis due to the fact that they are young patients with a relative short history of the disease. The correlation tests show a perfect parallel between the pH-metry scores and the endoscopic lesion. The correlation is so accurate that the pH-metry scores can be sufficient to prove GERD and the grade of esophagitis, the upper digestive endoscopy being reserved only for the cases that does not respond to the medical treatment or have other complications.
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