Comparative analysis of invasive and noninvasive methods of esophageal pathology diagnostics in children

Abstract

Invasive diagnostic methods (endoscopy, manometry, pH-monitoring) improved and became available not only for adolescents, but also for younger school age children. As well, screening diagnostics with non invasive methods (questionnaires, “red flags”, etc) are used widely as a first line diagnostics in modern world. Aim of the study: to compare diagnostic value of non invasive and invasive methods of GERD diagnostic in school age children. Materials and methods. Clinical cases of 31 patients 12–18 years old were observed. All patients had com- plaints typical to upper gastrointestinal tract (GIT) pathology, were interviewed with GERD questionnaire (GERDQ) and passed upper GIT endoscopy with acidity measurement by endoscopic pH-monitoring in esophagus and stom- ach. Endoscopy was performed by Olympus CV-140 and GIF P-140. The results and discussion. After interviewing with GERDQ patients were divided into 2 groups. Group “A” – 21 patient (70.4%), who got less than 8 points on GERDQ (risk of esophageal pathology is low). In the group “B” 10 children (29.6%) with ≥ 8 points in GERDQ which indicates GERD. Endoscopy showed in all patients of the group “B” signs of gastro-esophageal reflux (GER) and catarrhal inflammation or destructive changes (erosions) of esoph- ageal mucous membrane. Acidity in esophagus was ranged from 3.2 to 4.1. The average age of patients in this group was 14.9 years. In the group “A” 12 children (63.2%) did not have any pathological changes of the esophagus. Acidity was ranged from 5.3 to 6.5. 7 patients (36.8%) had signs of GER and acidity ranged from 3.8 to 4.7. The average age of patients in group was 13.2 years. Conclusions: Upper endoscopy and acidity measurements shoved changes typical to GERD in all patients with ≥ 8 points in GERDQ. Children with < 8 points in GERDQ in all cases did not have any visible changes of esophageal mucosa and only in 7 cases had GER with pH below 4.0. Analysis of the average age of patients shows that GERD is more common in elder patients (14.9 y.o.) Average age of GERD negative patients was 13.2 y.o. GERDQ is specific and informative method of QoL evaluation and can be used as a cheap screening method of the first line diagnostics of the esophageal pathology in school age children.