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논문 기본 정보

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저자정보
Elisa Blasi (Neurogastroenterology and Motility Unit Department of Gastroenterology Great Ormond Street Hospital for Children London UK) Ettore Stefanelli (Department of Medical and Surgical Sciences Pediatric Unit University Magna Graecia of Catanzaro Catanzaro Italy) Renato Tambucci (Digestive Endoscopy and Surgery Unit Bambino Gesù Children's Hospital - Research Institute IRCCS Rome Italy) Silvia Salvatore (Pediatric Department University of Insubria Hospital “F. Del Ponte” Varese Italy) Paola De Angelis (Digestive Endoscopy and Surgery Unit Bambino Gesù Children's Hospital - Research Institute IRCCS Rome Italy) Paolo Quitadamo (Department of Pediatrics A.O.R.N. Santobono-Pausilipon Napoli Italy) Claudia Pacchiarotti (NESMOS Department Faculty of Medicine and Psychology Sapienza University of Rome Pediatric Unit Sant’Andrea University Hospital Rome Italy) Giovanni Di Nardo (ESMOS Department Faculty of Medicine and Psychology Sapienza University of Rome Pediatric Unit Sant’Andrea University Hospital Rome Italy) Fanj Crocco (Pediatric and Pediatric Emergency Unit Children Hospital AO SS Antonio e Biagio e C. Arrigo Alessandria Italy) Valentina Giorgio (Department of Woman and Child Health and Public Health Public Health Area Fondazione Policlinico Universitario A. Gemelli IRCCS Rome Italy) Nicoletta Staropoli (A.O.U. Mater Domini University Magna Graecia of Catanzaro Catanzaro Italy) Simona Sestito (Department of Medical and Surgical Sciences Pediatric Unit University Magna Graecia of Catanzaro Catanzaro Italy) Efstratios Saliakellis (Neurogastroenterology and Motility Unit Department of Gastroenterology Great Ormond Street Hospital for Children London UK) Licia Pensabene (Department of Medical and Surgical Sciences Pediatric Unit University Magna Graecia of Catanzaro Catanzaro Italy)
저널정보
대한소화관운동학회(현 대한소화기능성질환.운동학회) Journal of Neurogastroenterology and Motility (JNM) Journal of Neurogastroenterology and Motility (JNM) Vol.29 No.2
발행연도
2023.4
수록면
156 - 165 (10page)
DOI
10.5056/jnm22115

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Background/AimsSince available data on pediatric non-erosive esophageal phenotypes (NEEPs) are scant, we investigated their prevalence and the phenotype-dependent treatment response in these children. MethodsOver 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. ResultsOut 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. ConclusionsFH 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.
#Children #Functional heartburn #Gastroesophageal reflux disease #Non-erosive reflux disease #Reflux hypersensitivity

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