Upper endoscopy for non‐acute non‐specific symptoms is seldom beneficial for children under the age of seven

Helin, Noora; Kolho, Kaija‐Leena; Rintala, Risto; Merras‐Salmio, Laura

doi:10.1111/apa.15027

Cited by 10 publications

(12 citation statements)

References 30 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Several more recent studies have identi ed certain basic patient characteristics including age that affect diagnostic yield. The diagnostic yield was found to be higher in teenagers (11,13,14,19) and lower in those aged < 7 years, especially in those without alarming symptoms (20). Our ndings suggest that EGD is valuable for evaluating patients with digestive symptoms; the prevalence of abnormal endoscopic ndings was 62.5% and that of abnormal histological ndings was 32.4%.…”

Section: Discussionmentioning

confidence: 62%

Pediatric esophagogastroduodenoscopy in China: indications, diagnostic yield, and factors associated with findings

Wang

Qiu

Chen

et al. 2022

Preprint

View full text Add to dashboard Cite

Background: Large-scale data on esophagogastroduodenoscopy (EGD) in China are scarce. This study aimed to assess the indications and diagnostic yield of EGD in children and the relationship between factors (such as age, sex, and indications) and diagnostic yield.Methods: We performed a prospective cross-sectional observational study involving patients aged < 18 years who underwent diagnostic EGD. The study was conducted in five children’s hospitals, each in a different city. Demographic features, indications for endoscopy, and endoscopic and histopathological findings were collected. Univariable and multivariable ordinal logistic regression analyses of the relationship between the factors and diagnostic yield were performed.Results: The study included 2268 patients (male/female ratio, 1.3:1) with a median age of 8.68 years. Among the 2268 children, the most frequent indications were abdominal pain in 1954 (86.2%), recurrent vomiting in 706 (31.1%), weight loss in 343 (15.1%), and others. The endoscopic yield was 62.5% and was the highest in patients with dysphagia (90.9%). The histologic yield was 32.4% and was the highest in patients with unexplained anemia (54.6%). On multivariable regression analysis, the endoscopic yield was associated with dysphagia, gastrointestinal (GI) bleeding, and recurrent vomiting, and the histologic yield was associated with weight loss and age. Different groups of patients with abdominal pain had variable probabilities of abnormal endoscopic findings.Conclusions: The most frequent indication of pediatric EGD is abdominal pain, with variable probabilities of abnormal endoscopic findings in different groups. Endoscopic yield and histologic yield are associated with certain alarming features.Trial registration: The trial registration number (TRN): NCT03603093 (ClinicalTrials. gov), Date of registration: July 18th, 2018

show abstract

Section: Discussionmentioning

confidence: 62%

Pediatric esophagogastroduodenoscopy in China: indications, diagnostic yield, and factors associated with findings

Wang

Qiu

Chen

et al. 2022

Preprint

View full text Add to dashboard Cite

show abstract

“…For this follow‐up study, we included children who had undergone a primary OGD to rule out oesophagitis at a median age of 2.6 years and who had been identified in our previous study ( n = 268) 11 …”

Section: Methodsmentioning

confidence: 99%

“…For this follow-up study, we included children who had undergone a primary OGD to rule out oesophagitis at a median age of 2.6 years and who had been identified in our previous study (n = 268). 11 The primary OGDs had been performed in 2006-2016 in Children's Hospital, University of Helsinki, the major tertiary care hospital in Finland. In early 2020, we had access to files of 254/268 children.…”

Section: Me Thodsmentioning

confidence: 99%

“…9,10 Moreover, in our previous study, we found that in young children with non-specific symptoms, oesophagogastroduodenoscopy (OGD) findings were scarce. 11 Apart from physical symptoms, psychological factors such as heightened symptom expectations, anxiety or depression, or beliefs relating to exposures that might trigger symptoms have been associated with subjective symptom perception 12 and may affect parents' perception of their child's symptoms. 13 This poses a challenge to clinicians, as also prognostic factors related to common early childhood non-specific upper GI symptoms are unclear.…”

mentioning

confidence: 99%

See 1 more Smart Citation

Parentally reported early childhood upper gastrointestinal symptoms alleviate at school age

2021

Self Cite

View full text Add to dashboard Cite

Aim This study estimated follow‐up outcomes for children presenting with troublesome upper gastrointestinal (GI) symptoms in early childhood. Methods We identified from our upper endoscopy registry children with undefined GI symptoms having undergone an oesophagogastroduodenoscopy to rule out oesophagitis at a median age of 2.6 years in 2006–2016. We included only those with normal findings. In early 2020, we performed a National Patient Data Repository and Prescription Service review to note patients' current GI symptoms, medications and medical consultations. We also employed a study‐specific questionnaire with a validated quality‐of‐life measure (the PedsQL). Results After a median of 7.9 years of follow‐up, the children (n = 199) had a median age of 10.6 years. Medical consultations related to upper GI symptoms were rare. However, parents reported recurrent GI symptoms in 24% of the children, and 41% followed a specific diet. Regular anti‐acid medication was in use in 3.5% of the cohort, more often when with a predisposing condition for reflux disease. The current quality of life was good. Conclusion Although some upper GI symptoms may persist after early childhood, patients without diseases predisposing to reflux disease have a good quality of life without GI‐related morbidity in school age.

show abstract

“…[11][12][13][14] In these studies, diagnosis was based on invasive tests such as pH probes, oesophageal manometry and endoscopy, which can be challenging to interpret in paediatrics. 12 15 All prior studies are more than two decades old and may not represent current practice.…”

Section: Introductionmentioning

confidence: 99%

Gastro-oesophageal reflux disease in children with neurological impairment: a retrospective cohort study

Dewan

Turner

Lethebe

et al. 2022

bmjpo

View full text Add to dashboard Cite

ObjectivesTo determine the incidence and prevalence of gastro-oesophageal reflux disease (GERD) diagnosis and treatment in children with neurological impairment (NI) along with relationship to key variables.DesignThis is a population-based retrospective cohort study.SettingThis study takes place in Alberta, Canada.PatientsChildren with NI were identified by hospital-based International Classification of Diseases (ICD) codes from 2006 to 2018.Main outcome measuresIncidence and prevalence of a GERD diagnosis identified by: (1) hospital-based ICD-10 codes; (2) specialist claims; (3) dispensation of acid-suppressing medication (ASM). Age, gender, complex chronic conditions (CCC) and technology assistance were covariates.ResultsAmong 10 309 children with NI, 2772 (26.9%) met the GERD definition. The unadjusted incidence rate was 52.1 per 1000 person-years (50.2–54.1). Increasing numbers of CCCs were associated with a higher risk of GERD. The HR for GERD associated with a gastrostomy tube was 4.56 (95% CI 4.15 to 5.00). Overall, 2486 (24.1%) of the children were treated with ASMs of which 1535 (61.7%) met no other GERD criteria. The incidence rate was 16.9 dispensations per year (95% CI 16.73 to 17.07). The prevalence of gastrojejunostomy tubes was 1.1% (n=121), surgical jejunostomy tubes was 0.7% (n=79) and fundoplication was 3.4% (n=351).ConclusionsThe incidence of GERD in children with NI greatly exceeds that of the general paediatric population. Similarly, incidence rate of medication dispensations was closer to the rates seen in adults particularly in children with multiple CCCs and gastrostomy tubes. Further research is needed to determine the appropriate use of ASMs balancing the potential for adverse effects in this population.

show abstract

Upper endoscopy for non‐acute non‐specific symptoms is seldom beneficial for children under the age of seven

Cited by 10 publications

References 30 publications

Pediatric esophagogastroduodenoscopy in China: indications, diagnostic yield, and factors associated with findings

Pediatric esophagogastroduodenoscopy in China: indications, diagnostic yield, and factors associated with findings

Parentally reported early childhood upper gastrointestinal symptoms alleviate at school age

Gastro-oesophageal reflux disease in children with neurological impairment: a retrospective cohort study

Contact Info

Product

Resources

About