Is the Diagnostic Trial with Proton Pump Inhibitors Reasonable for School Age Children with Gastroesophageal Reflux Symptoms?
10.5223/pghn.2019.22.6.511
- Author:
Jaeeun YANG
1
;
Jieon LEE
;
Hyunju LEE
;
Juyeon LEE
;
Young Mee YOUN
;
Jae Hong CHOI
;
Yoon Joo KIM
;
Hyun Sik KANG
;
Kyoung Hee HAN
;
Seung Hyo KIM
;
Ki Soo KANG
Author Information
1. Department of Pediatrics, Jeju National University School of Medicine, Jeju, Korea. kskang@jejunu.ac.kr
- Publication Type:Original Article
- Keywords:
Gastroesophageal reflux;
Proton pump inhibitor;
Child;
Empirical
- MeSH:
Child;
Classification;
Endoscopy;
Esophageal pH Monitoring;
Esophagitis;
Esophagitis, Peptic;
Female;
Gastroesophageal Reflux;
Humans;
Incidence;
Male;
Prevalence;
Prospective Studies;
Proton Pump Inhibitors;
Proton Pumps;
Protons
- From:Pediatric Gastroenterology, Hepatology & Nutrition
2019;22(6):511-517
- CountryRepublic of Korea
- Language:English
-
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.
