Pediatric Gastroenterology, Hepatology & Nutrition

The Korean Society of Pediatric Gastroenterology, Hepatology and Nutrition (대한소아소화기영양학회)
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Prevalence and Epidemiological Characteristics of Endoscopically Proven Reflux Esophagitis in Children in Korea

  • Yang, Aram (Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Kang, Ben (Department of Pediatrics, Kyungpook National University School of Medicine) ;
  • Choe, Jae Young (Department of Pediatrics, Kyungpook National University School of Medicine) ;
  • Kim, Hye Seung (Biostatistics and Clinical Epidemiology Center, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Kim, Kyunga (Biostatistics and Clinical Epidemiology Center, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Choe, Yon Ho (Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine)
  • Received : 2017.03.07
  • Accepted : 2017.05.26
  • Published : 2017.09.30
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Abstract

Purpose: The prevalence of reflux esophagitis (RE) has increased recently in Korea. Little is known concerning the prevalence and characteristics of RE in pediatric patients. This study investigated the prevalence and influence of risk factors in endoscopically proven RE in Korea in pediatric patients over a period of 14 years. Methods: A retrospective chart review of all patients between the ages of 1 month and 20 years who underwent esophagogastroduodenoscopy at Samsung Medical Center between 2001 and 2014 was carried out. Univariate and multivariate analyses were conducted to identify independent risk factors for RE. Results: The prevalence rate of endoscopically proven RE in this study was 28.7% (978/3,413). The prevalence of RE increased from 11.8% from 2001 to 2007 to 37.7% from 2008 to 2014. Multivariate logistic regression analysis revealed that residency in the Greater Gangnam area (odds ratio [OR], 1.21; 95% confidence interval [CI], 1.02-1.44) and age (OR, 1.13; 95% CI, 1.11-1.15) were significant predictive factors for the presence of RE. Conclusion: The prevalence rate of endoscopically proven pediatric RE has increased over the past 14 years. Residency and older age are more important independent risk factors for pediatric RE in Korea.

Keywords

References

  1. Nelson SP, Chen EH, Syniar GM, Christoffel KK. Prevalence of symptoms of gastroesophageal reflux during childhood: a pediatric practice-based survey. Pediatric practice research group. Arch Pediatr Adolesc Med 2000;154:150-4. https://doi.org/10.1001/archpedi.154.2.150
  2. Howard PJ, Maher L, Pryde A, Heading RC. Symptomatic gastro-oesophageal reflux, abnormal oesophageal acid exposure, and mucosal acid sensitivity are three separate, though related, aspects of gastro-oesophageal reflux disease. Gut 1991;32:128-32. https://doi.org/10.1136/gut.32.2.128
  3. Gremse DA. GERD in the pediatric patient: management considerations. MedGenMed 2004;6:13.
  4. Waring JP, Feiler MJ, Hunter JG, Smith CD, Gold BD. Childhood gastroesophageal reflux symptoms in adult patients. J Pediatr Gastroenterol Nutr 2002;35:334-8. https://doi.org/10.1097/00005176-200209000-00018
  5. Rudolph CD, Mazur LJ, Liptak GS, Baker RD, Boyle JT, Colletti RB, et al. Guidelines for evaluation and treatment of gastroesophageal reflux in infants and children: recommendations of the North American Society for Pediatric Gastroenterology and Nutrition. J Pediatr Gastroenterol Nutr 2001;32 Suppl 2:S1-31.
  6. Jung HK. Epidemiology of gastroesophageal reflux disease in Asia: a systematic review. J Neurogastroenterol Motil 2011;17:14-27. https://doi.org/10.5056/jnm.2011.17.1.14
  7. Fock KM, Talley NJ, Fass R, Goh KL, Katelaris P, Hunt R, et al. Asia-pacific consensus on the management of gastroesophageal reflux disease: update. J Gastroenterol Hepatol 2008;23:8-22.
  8. Murao T, Sakurai K, Mihara S, Marubayashi T, Murakami Y, Sasaki Y. Lifestyle change influences on GERD in Japan: a study of participants in a health examination program. Dig Dis Sci 2011;56:2857-64. https://doi.org/10.1007/s10620-011-1679-x
  9. Matsuzaki J, Suzuki H, Kobayakawa M, Inadomi JM, Takayama M, Makino K, et al. Association of visceral fat area, smoking, and alcohol consumption with reflux esophagitis and Barrett's esophagus in Japan. PLoS One 2015;10:e0133865. https://doi.org/10.1371/journal.pone.0133865
  10. Lundell LR, Dent J, Bennett JR, Blum AL, Armstrong D, Galmiche JP, et al. Endoscopic assessment of oesophagitis: clinical and functional correlates and further validation of the Los Angeles classification. Gut 1999; 45:172-80. https://doi.org/10.1136/gut.45.2.172
  11. Park KY, Chang SH. Gastro-esophageal reflux disease in healthy older children and adolescents. Pediatr Gastroenterol Hepatol Nutr 2012;15:220-8. https://doi.org/10.5223/pghn.2012.15.4.220
  12. Seo JK, Chi JG, Kim EC. Gastrofibersoscopic findings and Helicobacter-pylori gastritis in children with recurrent abdominal pain. J Korean Pediatr Soc 1992; 35:1646-56.
  13. Kwon HJ, Yi DY, Ryoo E, Cho KH, Son DW, Tcha H. Prevalence and risk factors associated with esophagitis in children with abdominal pain. Korean J Pediatr Gastroenterol Nutr 2008;11:103-9.
  14. Rey E, Elola-Olaso CM, Rodriguez-Artalejo F, Locke GR 3rd, Diaz-Rubio M. Prevalence of atypical symptoms and their association with typical symptoms of gastroesophageal reflux in Spain. Eur J Gastroenterol Hepatol 2006;18:969-75. https://doi.org/10.1097/01.meg.0000230081.53298.03
  15. Ou JL, Tu CC, Hsu PI, Pan MH, Lee CC, Tsay FW, et al. Prevalence and risk factors of erosive esophagitis in Taiwan. J Chin Med Assoc 2012;75:60-4. https://doi.org/10.1016/j.jcma.2011.12.008
  16. Gilger MA, El-Serag HB, Gold BD, Dietrich CL, Tsou V, McDuffie A, et al. Prevalence of endoscopic findings of erosive esophagitis in children: a population-based study. J Pediatr Gastroenterol Nutr 2008;47:141-6. https://doi.org/10.1097/MPG.0b013e31815eeabe
  17. Amano K, Adachi K, Katsube T, Watanabe M, Kinoshita Y. Role of hiatus hernia and gastric mucosal atrophy in the development of reflux esophagitis in the elderly. J Gastroenterol Hepatol 2001;16:132-6. https://doi.org/10.1046/j.1440-1746.2001.02408.x
  18. Shimazu T, Matsui T, Furukawa K, Oshige K, Mitsuyasu T, Kiyomizu A, et al. A prospective study of the prevalence of gastroesophageal reflux disease and confounding factors. J Gastroenterol 2005;40:866-72. https://doi.org/10.1007/s00535-005-1670-4
  19. Mishima I, Adachi K, Arima N, Amano K, Takashima T, Moritani M, et al. Prevalence of endoscopically negative and positive gastroesophageal reflux disease in the Japanese. Scand J Gastroenterol 2005;40:1005-9.
  20. Kinoshita Y, Kawanami C, Kishi K, Nakata H, Seino Y, Chiba T. Helicobacter pylori independent chronological change in gastric acid secretion in the Japanese. Gut 1997;41:452-8. https://doi.org/10.1136/gut.41.4.452
  21. Matsuura B, Nunoi H, Miyake T, Hiasa Y, Onji M. Obesity and gastrointestinal liver disorders in Japan. J Gastroenterol Hepatol 2013;28 Suppl 4:48-53. https://doi.org/10.1111/jgh.12238
  22. Marcon MA. Advances in the diagnosis and treatment of gastroesophageal reflux disease. Curr Opin Pediatr 1997;9:490-3.
  23. Krug E, Bergmeijer JH, Dees J, de Krijger R, Mooi WJ, Hazebroek FW. Gastroesophageal reflux and Barrett's esophagus in adults born with esophageal atresia. Am J Gastroenterol 1999;94:2825-8. https://doi.org/10.1111/j.1572-0241.1999.1423_c.x
  24. Taylor LA, Weiner T, Lacey SR, Azizkhan RG. Chronic lung disease is the leading risk factor correlating with the failure (wrap disruption) of antireflux procedures in children. J Pediatr Surg 1994;29:161-4; discussion 164-6. https://doi.org/10.1016/0022-3468(94)90311-5
  25. Gilger MA. Pediatric otolaryngologic manifestations of gastroesophageal reflux disease. Curr Gastroenterol Rep 2003;5:247-52. https://doi.org/10.1007/s11894-003-0027-5
  26. El-Serag HB, Graham DY, Satia JA, Rabeneck L. Obesity is an independent risk factor for GERD symptoms and erosive esophagitis. Am J Gastroenterol 2005;100:1243-50. https://doi.org/10.1111/j.1572-0241.2005.41703.x
  27. Fujiwara Y, Higuchi K, Shiba M, Yamamori K, Watanabe Y, Sasaki E, et al. Differences in clinical characteristics between patients with endoscopy-negative reflux disease and erosive esophagitis in Japan. Am J Gastroenterol 2005;100:754-8. https://doi.org/10.1111/j.1572-0241.2005.40966.x
  28. Du J, Liu J, Zhang H, Yu CH, Li YM. Risk factors for gastroesophageal reflux disease, reflux esophagitis and non-erosive reflux disease among Chinese patients undergoing upper gastrointestinal endoscopic examination. World J Gastroenterol 2007;13:6009-15. https://doi.org/10.3748/wjg.v13.45.6009
  29. Elitsur Y, Dementieva Y, Elitsur R, Rewalt M. Obesity is not a risk factor in children with reflux esophagitis: a retrospective analysis of 738 children. Metab Syndr Relat Disord 2009;7:211-4. https://doi.org/10.1089/met.2008.0069
  30. Maekawa T, Kinoshita Y, Okada A, Fukui H, Waki S, Hassan S, et al. Relationship between severity and symptoms of reflux oesophagitis in elderly patients in Japan. J Gastroenterol Hepatol 1998;13:927-30. https://doi.org/10.1111/j.1440-1746.1998.tb00763.x
  31. Grande L, Lacima G, Ros E, Pera M, Ascaso C, Visa J, et al. Deterioration of esophageal motility with age: a manometric study of 79 healthy subjects. Am J Gastroenterol 1999;94:1795-801. https://doi.org/10.1111/j.1572-0241.1999.01208.x
  32. Deprez P, Fiasse R. Healing of severe esophagitis improves esophageal peristaltic dysfunction. Dig Dis Sci 1999;44:125-33. https://doi.org/10.1023/A:1026614519572
  33. Ma XQ, Cao Y, Wang R, Yan X, Zhao Y, Zou D, et al. Prevalence of, and factors associated with, gastroesophageal reflux disease: a population-based study in Shanghai, China. Dis Esophagus 2009;22:317-22. https://doi.org/10.1111/j.1442-2050.2008.00904.x
  34. Ford AC, Forman D, Reynolds PD, Cooper BT, Moayyedi P. Ethnicity, gender, and socioeconomic status as risk factors for esophagitis and Barrett's esophagus. Am J Epidemiol 2005;162:454-60. https://doi.org/10.1093/aje/kwi218
  35. de Belmont Hollingshead A. Four factor index of social status. New Haven, CT: Yale University, 1975.
  36. Yim SH. Geographical features of social polarization in Seoul, South Korea. In: Mizuuchi T, ed. Representing local places and raising voices from below. Osaka: Osaka City University, 2003:31-40.
  37. Kim KH. Housing and the Korean economy. J Hous Econ 2004;13:321-41. https://doi.org/10.1016/j.jhe.2004.09.001
  38. Song EM, Jung HK, Jung JM. The association between reflux esophagitis and psychosocial stress. Dig Dis Sci 2013;58:471-7. https://doi.org/10.1007/s10620-012-2377-z
  39. Lee SP, Sung IK, Kim JH, Lee SY, Park HS, Shim CS. The effect of emotional stress and depression on the prevalence of digestive diseases. J Neurogastroenterol Motil 2015;21:273-82. https://doi.org/10.5056/jnm14116
  40. Treem WR, Davis PM, Hyams JS. Gastroesophageal reflux in the older child: presentation, response to treatment and long-term follow-up. Clin Pediatr (Phila) 1991;30:435-40. https://doi.org/10.1177/000992289103000705

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