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ARS Home » Plains Area » Houston, Texas » Children's Nutrition Research Center » Research » Publications at this Location » Publication #312486
Title: Decreased relative diagnostic yield of esophagogastroduodenoscopy in children with gastroparesis

Author
item WONG, GREGORY - BAYLOR COLLEGE OF MEDICINE
item SHULMAN, ROBERT - CHILDREN'S NUTRITION RESEARCH CENTER (CNRC)
item CHIOU, ERIC - TEXAS CHILDREN'S HOSPITAL
item CHUMPITAZI, BRUNO - BAYLOR COLLEGE OF MEDICINE

Submitted to: Clinical Gastroenterology and Hepatology
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 4/30/2013
Publication Date: 3/3/2014
Citation: Wong, G.K., Shulman, R.J., Chiou, E.H., Chumpitazi, B.P. 2014. Decreased relative diagnostic yield of esophagogastroduodenoscopy in children with gastroparesis. Clinical Gastroenterology and Hepatology. 48:231-235.

Interpretive Summary: Some children suffer from slow emptying of the stomach which affects their ability to eat normally. How fast or slow the stomach empties also affects how well the intestine can digest the food we eat. A number of tests were done to understand why a child might have slow stomach emptying. In this study we found that a commonly used test (endoscopy) did not seem to be helpful in children with this condition. Further prospective, larger, and multicenter studies are needed to validate our findings.

Technical Abstract: Esophagogastroduodenoscopy (EGD) and gastric emptying scintigraphy (GES) are commonly performed in the evaluation of children with upper gastrointestinal symptoms. It has been presumed, but not clarified, that gastroparesis increases the likelihood of identifying abnormalities on EGD. We sought to determine whether the presence of gastroparesis influenced the diagnostic yield of EGD in children. We conducted a retrospective chart review of children who underwent both an EGD and GES within 3 months of each other for evaluation of upper gastrointestinal symptoms (eg, abdominal pain). Clinical history (symptoms, comorbidities, medications, and surgical procedures), GES results, and EGD histology reports were captured. A total of 125 children (46% female) were included, of whom, 70 (56%) had gastroparesis. Thirty-three (26%) children had liquid meal GES (1.2 +/- 1.1 y of age, mean +/- SD) and 92 (64%) had solid meal GES (12.4 +/- 3.6 y of age). There was an overall trend toward a decreased frequency of biopsy abnormalities in those with gastroparesis (P=0.09). Those with gastroparesis identified through liquid meal GES were less likely to have reflux esophagitis on biopsy (P=0.002). Those with gastroparesis identified on solid meal GES were less likely to have gastritis (P=0.04). Symptoms, comorbidities, or medications were not predictive of GES or EGD results. Children with gastroparesis may be less likely to have biopsy abnormalities identified on EGD in comparison to those without gastroparesis. Further prospective, larger, and multicenter studies are needed to validate our findings.