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IB is significantly lower in infants (especially in the first months of life) compared with older children. Low IB in both proximal and distal esophagus in young infants may be related to anatomical and functional difference other than the presence of esophagitis.

Esophageal multiple intraluminal impedance baseline is an additional impedance parameter that was recently related to esophageal integrity. The aim of this study was to assess the relationship between mean esophageal impedance value and endoscopic findings in a large group of children. Children with symptoms of gastroesophageal reflux submitted to both endoscopy and impedance were included. Esophagitis was graded according to the Los Angeles classification. Mean impedance value was automatically calculated over 24-hour tracings. Data were adjusted for age through z-score transformation using percentiles normalized by the LMS (Lambda for the skew, Mu for the median, and Sigma for the generalized coefficient of variation) method. Nonparametric Mann-Whitney and Kruskal-Wallis tests, multiple, and stepwise regression were used. P-value <0.05 was considered as statistically significant. A total of 298 impedance tracings were analyzed. Endoscopic and histological esophagitis were detected in 30 and 29% patients, respectively. Median baseline z-score was significantly decreased both in proximal (P = 0.02) and distal (P = 0.01) esophagus in patients with endoscopic (but not histological) esophagitis. Patients with more severe esophagitis showed the lowest z-score. Bolus exposure index and the number of reflux episodes were the variables that were significantly associated with the baseline z-score. Impedance z-score is significantly decreased in infants and children with endoscopic esophagitis. Severity of esophagitis, bolus exposure index, and number of reflux episodes are factors influencing mean esophageal impedance.

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Objective: To investigate the presence and distribution of enamel defects and decayed-missed-filled teeth (DMF-T) in children and adolescents with mixed and permanent dentition who were diagnosed with celiac disease and to compare their oral findings with age and gender matched control group. Methods:A prospective study was conducted at King Hussein Medical Center on a total of 86 patients. Forty-three patients with celiac disease who were regular attendants to the pediatric gastrointestinal clinic were compared to 43 healthy dental patients who attended the general dental practice outpatient clinic at the same hospital and were selected to match the study group by age and gender. Enamel surfaces were explored clinically for the presence and distribution of any symmetrical defects or hypo-plastic changes and scored according to the classification proposed by Aien which consists of four grades. Both study and control groups were examined for the number of decayed, missed and filled teeth (DMF-T) index. Results:In both of the study and control groups, there were 26 females (60.5%) and 17 (39.5%) males. The mean age was 13.22±2.85 years for the study group and 13.35±2.59 years for the control group. Out of a total 86 patients, 37 (86.1%) of the celiac group was found to have enamel defects which was significantly higher than the control group (P value 0.007). The distribution of enamel defects was more in anterior than posterior teeth. The primary teeth in mixed dentition had shown zero enamel defects in both groups. The mean Decayed, Missed, Filled Teeth (DMF-T) was 7.15 for the study group while 6.78 for the control group with the P-value of 0.03 (decayed) 0.055 (missed) and 0.001 (filled). Caries free subjects comprise of 1 (2.32%) versus 11 (25.58%) in the study and control groups respectively. Conclusion:The celiac group showed statistically significant more enamel defect and decayed and less filled teeth compared to the control group.