Mukhametova E.M., Erdes S.I., Sergeeva T.N., Lokhmatov M.M. Erosive esophagitis in children: patterns of 24-hour pH monitoring // Gut 2009; 58 (Suppl II) A437
GASTRO 2009 UEGW/WCOG
21-25 November 2009, London – United Kingdom
Paediatric gastroenterology and hepatology III
Erosive esophagitis in children: patterns of 24-hour pH monitoring
E.M. Mukhametova, S.I. Erdes, T.N. Sergeeva, M.M. Lokhmatov
INTRODUCTION: Erosive esophagitis one of the most frequent presentations of gastroesophageal reflux disease. Esophageal pH monitoring is the gold standard technique for the detection of gastroesophageal reflux in adults and children.
AIMS & METHODS: to evaluate the frequency of abnormal gastroesophageal refluxes (GER) and patterns of acid production in children with erosive esophagitis (EE). 33 children with EE were included in the study (10 girls and 23 boys, age 9-17 year). All patients underwent upper endoscopy and 24-hour pH monitoring in esophagus and stomach. Esophagitis grade was defined endoscopically according to G. Tytgat classification.
RESULTS: 30 children (91%) had grade II esophagitis and 3 children (9%) had grade III esophagitis. Additionally all of them had endoscopic features of gastritis and duodenitis. Abnormal GER according esophageal 24-hour pH monitoring was found in 19 children (58%). The majority of these children had alkaline GER - in 9 of 19 children (47%). 6 children (32%) had acidic GER and 4 children (21%) had mixed abnormal GER. 24-hour pH monitoring in stomach showed hyperacidity in 56% and normacidity in 44% of children with EE. We also found duodenogastric reflux (DGR) in 25 of 33 children (76%). 15 of 19 (79%) children had combination of both abnormal GER and DGR. All patients with mixed type GER had concomitant DGR. We found the same combination in 7 of 9 patients with abnormal alkaline GER and in 4 of 6 patients with abnormal acidic GER accordingly.
CONCLUSION: Abnormal GER according to 24-hour pH monitoring was revealed in more than half of children with EE. Our preliminary data suggest that alkaline GER was prevailed. DGR was found in majority of patients with EE. Abnormal alkaline GER and mixed GER were accompanied with DGR more often. These results serve an evidence of significant motility disturbances of upper gastrointestinal tract in children with EE, and should be taken into consideration in treatment protocols.
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