Step-by-Step Diagnosis for Pathological Gastroesophageal Reflux in Children

Abstract

Objective of the study: to develop and validate an algorithm for step-by-step diagnosis of pathological gastroesophageal reflux (GER), depending on the severity of clinical course and age of a child. Materials and methods. The study involved 172 children aged 3 months to 3 years who received outpatient and inpatient treatment in Children’s city hospital № 3 and City clinical hospital № 9 named after prof A.I. Minakov in Odessa from June 2012 to February 2014. For screening examination of children, reflux questionnaire was used. Endoscopic examination of the esopha­gus has been used to confirm reflux esophagitis and to assess its severity. At the next stage, molecular genetic analysis of A3 collagen gene mutations has been carried out based on studying DNA of cells of oral mucous membrane. To confirm diagnosis, pH monitoring of the esophagus was performed. Statistical analysis of the findings has been carried out using the package Statistica 7.0 and Microsoft Excel 2010 with the integration of AtteStat 12.5, Internet calculator SISA (Simple Interactive Statistical Analysis). Results and conclusions. Step-by-step diagnosis for patholo­gical GER enables to establish and to confirm the diagnosis with minimal use of invasive techniques. The use of reflux questionnaire promotes early diagnosis of pathological GER and gastroesophageal reflux disease in children, differentiated approach to the application of invasive study methods.

Keywords

• children
• gastroesophageal reflux
• step-by-step diagnosis.