screening of gastroesophageal reflux in children first author: liana stanciu coordinator: professor...
TRANSCRIPT
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!