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Is the Diagnostic Trial with Proton Pump Inhibitors Reasonable for School Age Children with Gastroesophageal Reflux Symptoms? / 대한소아소화기영양학회지
Pediatric Gastroenterology, Hepatology & Nutrition ; : 511-517, 2019.
Article in English | WPRIM | ID: wpr-760891
ABSTRACT

PURPOSE:

On the basis of evidence, we aimed to reevaluate the necessity of the empirical proton pump inhibitor (PPI) trial for children with suspected gastroesophageal reflux disease (GERD).

METHODS:

We analyzed the frequency of GERD in 85 school-age children with gastroesophageal reflux (GER) symptoms, who received 24-hour esophageal pH monitoring and/or upper endoscopy. According to the reflux index (RI), the children were classified into normal (RI <5%), intermediate (5%≤ RI <10%), or abnormal (RI ≥10%) groups.

RESULTS:

Fifty six were female and 29 were male. Their mean age was 12.6±0.5 (±standard deviation) years (range 6.8–18.6). The RI analysis showed that the normal group included 76 patients (89.4%), the intermediate group included 6 patients (7.1%), and the abnormal group included 3 patients (3.5%). The DeMeester score was 5.93±4.65, 14.68±7.86 and 40.37±12.96 for the normal, intermediate and abnormal group, respectively (p=0.001). The longest reflux time was 5.56±6.00 minutes, 9.53±7.84 minutes, and 19.46±8.35 minutes in the normal, intermediate, and abnormal group, respectively (p=0.031). Endoscopic findings showed reflux esophagitis in 7 patients. On the basis of the Los Angeles Classification of Esophagitis, 5 of these patients were included in group A, 1 patient, in group B and 1 patient, in group C.

CONCLUSION:

The incidence of GERD was very low in school-age children with GER symptoms. Therefore, injudicious diagnostic PPI trials would be postponed until the actual prevalence of GERD is verified in future prospective studies.
Subject(s)

Full text: Available Index: WPRIM (Western Pacific) Main subject: Protons / Esophagitis, Peptic / Gastroesophageal Reflux / Incidence / Prevalence / Prospective Studies / Classification / Proton Pumps / Endoscopy / Esophagitis Type of study: Diagnostic study / Incidence study / Observational study / Prevalence study / Prognostic study / Risk factors Limits: Child / Female / Humans / Male Language: English Journal: Pediatric Gastroenterology, Hepatology & Nutrition Year: 2019 Type: Article

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Full text: Available Index: WPRIM (Western Pacific) Main subject: Protons / Esophagitis, Peptic / Gastroesophageal Reflux / Incidence / Prevalence / Prospective Studies / Classification / Proton Pumps / Endoscopy / Esophagitis Type of study: Diagnostic study / Incidence study / Observational study / Prevalence study / Prognostic study / Risk factors Limits: Child / Female / Humans / Male Language: English Journal: Pediatric Gastroenterology, Hepatology & Nutrition Year: 2019 Type: Article