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Prevalence of Non-erosive Esophageal Phenotypes in Children: A European Multicenter Study.
- Source :
-
Journal of Neurogastroenterology & Motility . Apr2023, Vol. 29 Issue 2, p156-165. 10p. - Publication Year :
- 2023
-
Abstract
- Background/Aims Since available data on pediatric non-erosive esophageal phenotypes (NEEPs) are scant, we investigated their prevalence and the phenotype-dependent treatment response in these children. Methods Over a 5-year period, children with negative upper endoscopy, who underwent esophageal pH-impedance (off-therapy) for persisting symptoms not responsive to proton pump inhibitor (PPI)-treatment, were recruited. Based on the results of acid reflux index (RI) and symptom association probability (SAP), patients were categorized into: (1) abnormal RI (non-erosive reflux disease [NERD]), (2) normal RI and abnormal SAP (reflux hypersensitivity [RH]), (3) normal RI and normal SAP (functional heartburn [FH]), and (4) normal RI and not-reliable SAP (normal-RI-not otherwise-specified [normal-RI-NOS]). For each subgroup, treatment response was evaluated. Results Out of 2333 children who underwent esophageal pH-impedance, 68 cases, including 18 NERD, 14 RH, 26 FH, and 10 normal-RI-NOS were identified as fulfilling the inclusion criteria and were analyzed. Considering symptoms before endoscopy, chest pain was more reported in NERD than in other cases (6/18 vs 5/50, P = 0.031). At long-term follow-up of 23 patients (8 NERD, 8 FH, 2 RH, and 5 normal-RI-NOS): 17 were on PPIs and 2 combined alginate, 1 (FH) was on benzodiazepine + anticholinergic, 1 (normal-RI-NOS) on citalopram, and 3 had no therapy. A complete symptom-resolution was observed in 5/8 NERD, in 2/8 FH, and in 2/5 normal-RI-NOS. Conclusions FH may be the most common pediatric NEEP. At long-term follow-up, there was a trend toward a more frequent complete symptom resolution with PPI-therapy in NERD patients while other groups did not benefit from extended acid-suppressive-treatment. [ABSTRACT FROM AUTHOR]
- Subjects :
- *PROTON pump inhibitors
*PHENOTYPES
*CHEST pain
*PARASYMPATHOLYTIC agents
Subjects
Details
- Language :
- English
- ISSN :
- 20930879
- Volume :
- 29
- Issue :
- 2
- Database :
- Academic Search Index
- Journal :
- Journal of Neurogastroenterology & Motility
- Publication Type :
- Academic Journal
- Accession number :
- 162984590
- Full Text :
- https://doi.org/10.5056/jnm22115