BACKGROUND/AIMS: Gastroesophageal reflux disease (GERD) is common in children. Recurrent exposure to gastric acid in GERD may contribute to tooth erosion. METHODS: In this prospective study, 54 GERD patients qualified according to endoscopy, pH-metry, and the GERD questionnaire and 58 healthy controls qualified by the GERD questionnaire were assessed. Two groups underwent dental evaluations for the presence, severity, and patterns of erosion and for the stage of dentition using a Tooth Wear Index. The health care providers who performed the dental exams did not know which children had been diagnosed with GERD. RESULTS: A total of 112 children, 3 to 12 years old were enrolled in the study, and 53 of 54 (98.1%) GERD patients and 11 of 58 (19.0%) controls had dental erosions (p<0.0001). In GERD patients, the posterior occlusal surfaces of milk teeth were more affected (p<0.0001). There was no correlation between GERD and the affected surfaces in permanent teeth, nor in the patterns or erosion grades (localized or general). In both groups, milk teeth had more erosions than permanent teeth, but the difference was not statistically significant. CONCLUSIONS: According to this study, there is a positive correlation between GERD and dental erosion. Posterior occlusal surface erosions in milk teeth could indicate GERD.
Child ; Dentition ; Endoscopy ; Gastric Acid ; Gastroesophageal Reflux ; Health Personnel ; Humans ; Milk ; Prospective Studies ; Questionnaires ; Tooth ; Tooth Erosion ; Tooth Wear

BACKGROUND/AIMS: Calprotectin is a 36.5 kD calcium and zinc binding protein in the S100 protein family. Fecal calprotectin levels are elevated in patients with inflammatory bowel disease and some other gastrointestinal disorders such as colorectal carcinoma. We decided to evaluate the fecal calprotectin level to see if it was able to distinguish between functional and organic causes of constipation. METHODS: Seventy-six children aged 1 to 120 months that all underwent deep rectal mucosa biopsies at Children Medical Center from November 2010 till September 2011 were recruited. Nineteen cases were diagnosed as Hirschsprung's disease and 57 of the patients had nerve ganglion cells in their biopsies. Calprotectin concentration was analyzed by the ELISA method. RESULTS: Although there was a significant difference between the median of the two groups (p=0.036), the median was not above the predetermined cutoff value of 50 microg/g. CONCLUSIONS: We propose that fecal calprotectin, using the above cutoff value, has limited value in differentiating functional constipation from Hirschsprung's disease.
Age Factors ; Child ; Child, Preschool ; Constipation/*diagnosis ; Diagnosis, Differential ; Enzyme-Linked Immunosorbent Assay ; Feces/chemistry ; Female ; Hirschsprung Disease/*diagnosis/metabolism/pathology ; Humans ; Infant ; Infant, Newborn ; Intestinal Mucosa/pathology ; Leukocyte L1 Antigen Complex/*analysis ; Male ; Sex Factors

BACKGROUND/AIMS: Gastroesophageal reflux disease (GERD) and cow's milk allergy (CMA) are two common conditions that occur in infancy. This study was performed to investigate the frequency of CMA in a group of patients with GERD. METHODS: Eighty-one children with signs and symptoms of GERD were enrolled in this study. All subjects received omeprazole for 4 weeks after the initial evaluation. Empirical elimination of cow's milk from the diet was started for the patients who did not respond to the omeprazole treatment. RESULTS: Seventy-two cases presented with gastrointestinal signs and symptoms, whereas the remaining nine cases presented with respiratory complaints. After the initial treatment with omeprazole, two thirds of the cases (54 patients, 66.7%) responded well, and all of their symptoms were resolved. Cow's milk was eliminated from the diets of the remaining 27 patients. All signs and symptoms of GERD were resolved in this group after a 4 week elimination of cow's milk from the diet. CONCLUSIONS: A diagnosis of CMA was considered in one third of the pediatric cases with signs and symptoms of GERD. This finding shows that CMA can mimic or aggravate all signs and symptoms of severe GERD during infancy.
Child ; Diet ; Food Hypersensitivity ; Gastroesophageal Reflux ; Humans ; Hydrazines ; Milk ; Milk Hypersensitivity ; Omeprazole