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Rising Prevalence of Mild Chronic Gastritis in Children: A Single Center Experience
Rohit Josyabhatla1, Mary Lauren Wood2, Amber Gafur3
1Division of Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, The University of Texas Health Science Center at Houston, McGovern Medical School, Houston, TX, USA.
Insights
Pediatric chronic gastritis prevalence significantly increased over a decade, with higher rates observed in recent years. This trend highlights a growing concern in pediatric gastrointestinal health.
Area of Science:
- Pediatric Gastroenterology
- Gastrointestinal Endoscopy
- Histopathology
Background:
- Upper gastrointestinal endoscopy is a crucial diagnostic tool for evaluating pediatric gastrointestinal symptoms.
- Chronic gastritis in children can lead to various symptoms, including abdominal pain, vomiting, failure to thrive, and diarrhea.
- Understanding trends in pediatric gastrointestinal conditions is vital for public health and clinical practice.
Purpose of the Study:
- To analyze trends in upper endoscopic and histological findings in children over a 10-year period.
- To investigate the prevalence of chronic gastritis in pediatric patients across three distinct cohorts.
- To compare endoscopic findings between cases with gastritis and controls.
Main Methods:
- Retrospective analysis of upper endoscopic and histological data from three pediatric cohorts (2011, 2015, 2019).
- Inclusion of 579 pediatric patients, categorized by cohort year.
- Assessment of common presenting symptoms such as abdominal pain, vomiting, failure to thrive, and diarrhea.
Main Results:
- Histological evidence of chronic gastritis significantly increased from 29% in 2011 to 68% in 2019 (P < .001).
- The prevalence of normal endoscopic gastric findings was lower in cases (76%) compared to controls (90%) (P < .001).
- A statistically significant difference in endoscopic esophageal grading was observed over time (P = .008).
Conclusions:
- A significant rise in the prevalence of mild chronic or non-specific gastritis has been observed in the pediatric population over the past decade.
- The increasing prevalence of pediatric gastritis warrants further investigation into underlying causes and long-term implications.
- These findings underscore the importance of regular endoscopic and histological evaluations for children presenting with relevant gastrointestinal symptoms.
Objectives And Methods:
We analyzed upper endoscopic and histological findings in 3 cohorts of children undergoing upper gastrointestinal endoscopy over a 10-year period. Five hundred seventy-nine patients were identified, with 244 (42%), 199 (35%), and 136 (23%) in the 2011, 2015, and 2019 cohorts, respectively. The most common symptoms and signs were abdominal pain, vomiting, failure to thrive, and diarrhea.
Results:
The number of patients who had histological evidence of chronic gastritis increased from 2011 (n = 70, 29%) to 2015 (n = 106, 53%) and 2019 (n = 92, 68%; P < .001). The prevalence of "normal" endoscopic gastric findings was higher in controls (n = 247, 90%) compared to cases (n = 201, 76%; P < .001). There was a small but statistically significant difference in endoscopic esophageal grading (P = .008) over time, with lower grades being more prevalent in 2011 compared to 2015 (P = .026) and 2019 (P = .001). Crude comparisons of the predictors (sex, weight percentile, payor type, month of endoscopy, symptom duration, PPI exposure, and endoscopic stomach findings) yielded no difference between cases and controls.
Conclusions:
There has been a significant rise in the prevalence of mild chronic gastritis or non-specific gastritis over the last decade in our population.
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