Background
Esophagogastroduodenoscopy (EGD) and gastric emptying scintigraphy (GES) are commonly performed in the evaluation of children with upper gastrointestinal (GI) symptoms. It has been presumed, but not clarified, that gastroparesis increases the likelihood of identifying abnormalities on EGD. We sought to determine whether the presence of gastroparesis influenced the diagnostic yield of EGD in children.
Methods
We conducted a retrospective chart review of children who underwent both an EGD and gastric emptying scintigraphy (GES) within 3 months of each other for evaluation of upper GI symptoms (e.g. abdominal pain). Clinical history (symptoms, comorbidities, medications, and surgical procedures), GES results, and EGD histology reports were captured.
Results
125 children (46% female) were included, of whom, 70 (56%) had gastroparesis. 33 (26%) children had liquid-meal GES (1.2 ± 1.1 years of age, mean ± SD) and 92 (64%) had solid-meal GES (12.4 ± 3.6 years of age). There was an overall trend toward a decreased frequency of biopsy abnormalities in those with gastroparesis (P=0.09). Those with gastroparesis identified via liquid-meal GES were less likely to have reflux esophagitis on biopsy (P=0.002). Those with gastroparesis identified on solid-meal GES were less likely to have gastritis (P=0.04). Symptoms, comorbidities, or medications were not predictive of GES or EGD results.
Conclusions
Children with gastroparesis may be less likely to have biopsy abnormalities identified on EGD in comparison to those without gastroparesis. Further prospective, larger, and multicenter studies are needed to validate our findings.