Kalpesh Thakkar1, Leon Chen2, Mary E Tessier2, Mark A Gilger2. 1. Section of Pediatric Gastroenterology, Hepatology and Nutrition, Baylor College of Medicine, Houston, Texas. Electronic address: kthakkar@bcm.edu. 2. Section of Pediatric Gastroenterology, Hepatology and Nutrition, Baylor College of Medicine, Houston, Texas.
Abstract
BACKGROUND & AIMS: Chronic abdominal pain is the most common indication for esophagogastroduodenoscopy (EGD) in children. However, little is known about the accuracy of EGD-based diagnosis or the outcomes of the patients who undergo this procedure. We examined the diagnostic yield of EGD and short-term outcomes of children who underwent this procedure for chronic abdominal pain. METHODS: We conducted a prospective study of 290 children (4-18 years old; mean age, 11.9 ± 3.5 years; 93 girls) who underwent EGD for the primary indication of chronic abdominal pain (216 with at least 1 alarm feature) at a US pediatric gastroenterology referral center. We collected data on demographic features (age, sex), clinical characteristics (alarm features, Rome III criteria), and EGD results for each patient. All subjects with diagnostic lesions were followed for at least 1 year after EGD to determine short-term outcomes. RESULTS: Overall, EGD provided an accurate diagnosis for 109 children (38%). Diagnoses included esophagitis (21.0%), eosinophilic gastroenteritis (4.1%), eosinophilic esophagitis (3.8%), Helicobacter pylori infection (2.0%), celiac disease (0.6%), and Crohn's disease (0.4%). Short-term outcomes were available for 81% of patients with diagnostic findings, and medical therapy was effective in approximately 67% of these children. CONCLUSIONS: EGD is valuable for the diagnosis of children with abdominal pain, with a 38% diagnostic yield. EGD identified disorders for which medical therapy was effective in 67% of children during the year after diagnosis.
BACKGROUND & AIMS:Chronic abdominal pain is the most common indication for esophagogastroduodenoscopy (EGD) in children. However, little is known about the accuracy of EGD-based diagnosis or the outcomes of the patients who undergo this procedure. We examined the diagnostic yield of EGD and short-term outcomes of children who underwent this procedure for chronic abdominal pain. METHODS: We conducted a prospective study of 290 children (4-18 years old; mean age, 11.9 ± 3.5 years; 93 girls) who underwent EGD for the primary indication of chronic abdominal pain (216 with at least 1 alarm feature) at a US pediatric gastroenterology referral center. We collected data on demographic features (age, sex), clinical characteristics (alarm features, Rome III criteria), and EGD results for each patient. All subjects with diagnostic lesions were followed for at least 1 year after EGD to determine short-term outcomes. RESULTS: Overall, EGD provided an accurate diagnosis for 109 children (38%). Diagnoses included esophagitis (21.0%), eosinophilic gastroenteritis (4.1%), eosinophilic esophagitis (3.8%), Helicobacter pylori infection (2.0%), celiac disease (0.6%), and Crohn's disease (0.4%). Short-term outcomes were available for 81% of patients with diagnostic findings, and medical therapy was effective in approximately 67% of these children. CONCLUSIONS: EGD is valuable for the diagnosis of children with abdominal pain, with a 38% diagnostic yield. EGD identified disorders for which medical therapy was effective in 67% of children during the year after diagnosis.
Authors: Glenn T Furuta; David Forbes; Chris Boey; C Dupont; Phil Putnam; Sk Roy; Aderbal Sabrá; Anadina Salvatierra; Yuichiro Yamashiro; S Husby Journal: J Pediatr Gastroenterol Nutr Date: 2008-08 Impact factor: 2.839
Authors: Andrée Rasquin; Carlo Di Lorenzo; David Forbes; Ernesto Guiraldes; Jeffrey S Hyams; Annamaria Staiano; Lynn S Walker Journal: Gastroenterology Date: 2006-04 Impact factor: 22.682
Authors: Robert C Kapel; Jocelyne K Miller; Carlos Torres; Saime Aksoy; Richard Lash; David A Katzka Journal: Gastroenterology Date: 2008-02-14 Impact factor: 22.682
Authors: Glenn T Furuta; Chris A Liacouras; Margaret H Collins; Sandeep K Gupta; Chris Justinich; Phil E Putnam; Peter Bonis; Eric Hassall; Alex Straumann; Marc E Rothenberg Journal: Gastroenterology Date: 2007-08-08 Impact factor: 22.682
Authors: Andrée Rasquin; Carlo Di Lorenzo; David Forbes; Ernesto Guiraldes; Jeffrey S Hyams; Annamaria Staiano; Lynn S Walker Journal: Gastroenterology Date: 2006-04 Impact factor: 22.682
Authors: Kamran Badizadegan; David M Vanlandingham; Wesley Hampton; Kimberly M Thompson Journal: BMC Health Serv Res Date: 2020-10-20 Impact factor: 2.655