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Parentally reported early childhood upper gastrointestinal symptoms alleviate at school age
Noora Helin1, Kaija-Leena Kolho1,2, Laura Merras-Salmio1
1Children's Hospital, Paediatric Research Centre, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
Insights
Most children with early childhood upper gastrointestinal symptoms have good quality of life in school age. Persistent symptoms and specific diets were noted, but serious morbidity was rare in this pediatric study.
Area of Science:
- Pediatric Gastroenterology
- Clinical Outcomes Research
Background:
- Early childhood upper gastrointestinal (GI) symptoms are common but often lack clear diagnosis.
- Long-term outcomes for children with initially undefined GI symptoms require further investigation.
Purpose of the Study:
- To estimate the follow-up outcomes for children presenting with troublesome upper GI symptoms in early childhood.
- To assess the persistence of GI symptoms, need for medication, and quality of life in school-aged children.
Main Methods:
- Retrospective review of an upper endoscopy registry for children with normal findings (n=199) after oesophagogastroduodenoscopy.
- Follow-up data collected via National Patient Data Repository, Prescription Service review, and a study-specific questionnaire including the PedsQL.
Main Results:
- After a median 7.9-year follow-up, 24% of children reported recurrent GI symptoms, and 41% followed specific diets.
- Medical consultations for upper GI symptoms were infrequent; 3.5% used anti-acid medication, more common in those with predisposing conditions.
- The overall quality of life in school age was reported as good.
Conclusions:
- While some upper GI symptoms may persist, children without predisposing conditions for reflux disease generally experience good quality of life.
- Pediatric patients without underlying diseases show minimal GI-related morbidity in school age, suggesting a favorable long-term prognosis.
Aim:
This study estimated follow-up outcomes for children presenting with troublesome upper gastrointestinal (GI) symptoms in early childhood.
Methods:
We identified from our upper endoscopy registry children with undefined GI symptoms having undergone an oesophagogastroduodenoscopy to rule out oesophagitis at a median age of 2.6 years in 2006-2016. We included only those with normal findings. In early 2020, we performed a National Patient Data Repository and Prescription Service review to note patients' current GI symptoms, medications and medical consultations. We also employed a study-specific questionnaire with a validated quality-of-life measure (the PedsQL).
Results:
After a median of 7.9 years of follow-up, the children (n = 199) had a median age of 10.6 years. Medical consultations related to upper GI symptoms were rare. However, parents reported recurrent GI symptoms in 24% of the children, and 41% followed a specific diet. Regular anti-acid medication was in use in 3.5% of the cohort, more often when with a predisposing condition for reflux disease. The current quality of life was good.
Conclusion:
Although some upper GI symptoms may persist after early childhood, patients without diseases predisposing to reflux disease have a good quality of life without GI-related morbidity in school age.
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