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World J Gastrointest Endosc. Aug 16, 2012; 4(8): 339-346
Published online Aug 16, 2012. doi: 10.4253/wjge.v4.i8.339
Managing gastroesophageal reflux disease in children: The role of endoscopy
Helena AS Goldani, Daltro LA Nunes, Cristina T Ferreira
Helena AS Goldani, Daltro LA Nunes, Cristina T Ferreira, Department of Pediatrics and Gastroenterology Unit, Hospital de Clinicas de Porto Alegre, Faculdade de Medicina da Universidade Federal do Rio Grande do Sul, 90035-903 Porto Alegre-RS, Brazil
Author contributions: All authors contributed to this paper.
Supported by Hospital de Clinicas de Porto Alegre, Porto Alegre-RS, Brazil
Correspondence to: Helena AS Goldani, MD, PhD, Department of Pediatrics and Gastroenterology Unit, Hospital de Clinicas de Porto Alegre, Faculdade de Medicina da Universidade Federal do Rio Grande do Sul, Rua Ramiro Barcelos 2350, 90035-903 Porto Alegre-RS, Brazil. hgoldani@hcpa.ufrgs.br
Telephone: +55-51-33598293 Fax: +55-51-33598123
Received: October 14, 2011
Revised: June 28, 2012
Accepted: August 8, 2012
Published online: August 16, 2012
Abstract

Gastroesophageal reflux disease (GERD) is a growing problem in the pediatric population and recent advances in diagnostics and therapeutics have improved their management, particularly the use of esophago-gastroduodenoscopy (EGD). Most of the current knowledge is derived from studies in adults; however there are distinct features between infant onset and adult onset GERD. Children are not just little adults and attention must be given to the stages of growth and development and how these stages impact the disease management. Although there is a lack of a gold standard test to diagnose GERD in children, EGD with biopsy is essential to assess the type and severity of tissue damage. To date, the role of endoscopy in adults and children has been to assess the extent of esophagitis and detect metaplastic changes complicating GERD; however the current knowledge points another role for the EGD with biopsy that is to rule out other potential causes of esophagitis in patients with GERD symptoms such as eosinophilic esophagitis. This review highlights special considerations about the role of EGD in the management of children with GERD.

Keywords: Endoscopy; Gastroesophageal reflux; Esophagitis; Infants; Children