SCREENING OF GASTROESOPHAGEAL REFLUX IN CHILDREN

First author: Liana Stanciu

Coordinator: Professor Doctor Oana Marginean

Coauthors : Cosmin Oprea and Maria Oana Marginean

Gastroesophageal reflux disease (GERD) is one of the most common and frequent pathologies encountered in pediatrics and pediatric gastroenterology centers.

Gastroesophageal reflux occurs several times a day for infants, children, adolescents and adults when it is asymptomatic or it produces few symptoms.

WHY IS IT IMPORTANT TO ELABORATE A SCREENING TEST FOR THE EVOLUTION OF

GASTROESOPHAGEAL REFLUX?

Gastroesophageal reflux+

symptoms/complications with significant morbidity

Gastroesophageal reflux disease

Objective: To determine whether the proposed questionnaire is able to establish the gastroesophageal reflux in children.

Material and Method: analytic observational prospective

study 50 pediatric pacients 2 questionnaires adapted to 2

groups : children aged 0 to 8 years and children over 8 years

questions based on age,gender and presence of significant symptoms

IF,IN THE LAST 7 DAYS OR MORE,BEFORE THE VISIT TO THE DOCTOR,YOUR CHILD,PRESENTED

THE FOLLOWING SYMPTOMS:

weight loss regurgitation or

vomiting frequently refusing food or

irritability even if is hungry

crying during meals or 1 hour after eating

hiccups nocturne coughing or

wheezing without fever stopping breathing or

choking episodes

nausea or vomiting frequently

bitter or sour taste in the mouth

painful swallowing of food

epigastric pain retrosternal burn nocturne coughing or

wheezing without fever

Children aged 0 to 8 years Children over 8 years

Criterion for identification of gastroesophageal reflux disease in

children : If the child has submitted at least 2 or

more of the symptoms listed can be considered suspect of

gastroesophageal reflux disease.

Presence of disease

Absence of disease

Total

Children over 8 years

14 5 19

Children aged 0 to 8 years

10 21 31

Total 24 26 50

p value = 0,008 < 0,05 p value is highly statistically significant

OR = 5.88 >1 GERD is approximately 6 times more frequently in children over 8 years from the case group compared to the control group

Variable Case group

Control group

p value OR

weight loss 5 3 0,45 2,01

vomiting 10 6 0,22 2,38

refusing food

7 3 0,16 3,15

crying 2 0 0,22 -

hiccups 4 3 0,69 1,53

nocturne coughing

10 3 0,02 5,47

stopping breathing

5 3 0,45 2,01

bitter or sour taste

5 1 0,09 6,57

painful swallowing

9 1 0,004 15

epigastric pain

6 1 0,04 8,3

retrosternal burn

6 0 0,008 -

Results : 1. The symptoms which are significantly

correlated with the gastroesophageal reflux disease are:

nocturne coughing (p=0,02, OR=5,47)painful swallowing (p<0,01, OR=15)epigastric pain (p=0,04, OR=8,3)

2. Gastroesophageal reflux disease is more common in females (58%) and is approximately 6 times more frequently in children over 8 years from the case group compared to the control group (p<0,01,OR=5,88).

Discussions: nocturne coughing : p=0,02 and OR=5,47 OR=5,47 > 1 GERD is

approximately 5 times more frequently in children from the case group in both age groups

painful swallowing : p=0,004 and OR=15 OR=15 > 1 GERD is 15 times more

frequently in children over 8 years from the case group compared to the control group

epigastric pain : p=0,04 and OR=8,3 OR=8,3 > 1 GERD is approximately 8

times more frequently in children over 8 years from the case group compared to the control group

WHICH ARE THE ADVANTAGES OF USING THIS SCREENING TEST?

non-invasive easy to apply requires low cost price fast to use may be applied continuously for

suspicious cases effective because it is able to detect

early GERD in order to paediatric approach for investigations and expert consult

Conclusions: 1. Gastroesophageal reflux disease is a

condition which has become more frequent in children over the few years and is associated in this study with these symptoms: nocturne coughing, painful swallowing and epigastric pain.

2. Gastroesophageal reflux disease is more common in females and is more frequently in children over 8 years.

3.This screening test is a very useful tool for the diagnosis of gastroesophageal reflux because of its advantages.

Bibliography : http://www.sciencedirect.com/science/

article/pii/S0021755713002027 http://www.naspghan.org/files/docume

nts/pdfs/position-papers/FINAL%20-%20JPGN%20GERD%20guideline.pdf

Thank you for your attention!