Eesophagogastroduodenoscopy in paediatrics: does abiding by the international guidelines lead to appropriate management? A cross-sectional study

Abstract

Objectives Esophagogastroduodenoscopy (EGD) is one of the most practiced procedures in paediatric gastroenterology. As with all other procedures, it is guided and controlled by specific guidelines developed and approved internationally. The European Society for Paediatric Gastroenterology Hepatology and Nutrition (ESPGHAN) and the American Society for Gastrointestinal Endoscopy (ASGE) guidelines are two of the most followed guidelines in paediatric gastroenterology. This study aimed to determine how optimal patient condition management is when following international paediatric gastroenterology guidelines and to correlate the appropriateness of EGD and other variables with positive or negative findings on EGD.DesignA cross-sectional retrospective cohort of all first-time diagnostic upper endoscopies was conducted between 1 January 2016 and 1 February 2020, in Prince Hamzah Hospital in Jordan.ParticipantsPaediatric patients between 9 months and 14 years of age with indications for EGD.ResultsOverall, 529 diagnostic EGDs were performed during the study period. Helicobacter pylori-associated gastritis was the most common final diagnosis in 247 patients (47%). Furthermore, 488 (92%) EGDs were deemed appropriate, while 41 (7.7%) were considered inappropriate. Finally, 74.0% of all biopsies performed had positive contributive findings.ConclusionsAbiding by international guidelines in paediatric gastroenterology can optimise care for paediatric patients. General paediatricians are urged to follow guidelines rigorously when referring patients to minimise inappropriate procedures.

Antimicrobial Resistance Molecular Mechanisms of Helicobacter pylori in Jordanian Children: A Cross-Sectional Observational Study

“…A negative H. pylori status was confirmed when histology and culture were negative. The 2016 ESPGHAN/NASPGHAN guidelines were followed to determine medical management regimens and dosages [ 7 , 11 ]. The treating physicians investigated and confirmed compliance with therapy.…”

“…Given the limited number of antibiotics that are appropriate for H. pylori eradication in children, and the worldwide increase in antibiotic resistance, the recent European Society for Pediatric Gastroenterology Hepatology and Nutrition/North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition (ESPGHAN/NASPGHAN) have recommended antimicrobial susceptibility testing to guide H. pylori eradication treatment in children [ 7 , 11 ]. However, due to the fastidious culture of H. pylori and the lack of an easy and cost-effective testing method, antimicrobial susceptibility testing for H. pylori is almost universally unavailable in medical centers [ 12 , 13 , 14 , 15 , 16 ].…”

Chronic gastritis in pediatrics

“…Clear indications are necessary when prescribing endoscopic examinations for children. In one publication, it was demonstrated that only 92.2% of all diagnostic esophagogastroduodenoscopies were justified, while 7.8% were prescribed incorrectly [29].…”