ABSTRACT
INTRODUCTION AND OBJECTIVE: Eosinophilic esophagitis is a chronic, immune-mediated disease described in case series and publications worldwide. Over the past twenty years, the authors of different studies have attempted to evaluate its incidence and prevalence. The objetive of the present study was to estimate the prevalence of eosinophilic esophagitis in a group of children seen at 36 pediatric gastroenterology centers in ten Latin American countries. MATERIALS AND METHODS: A multicenter, observational, and cross-sectional study was conducted that estimated the period prevalence of eosinophilic esophagitis in children seen at outpatient consultation and that underwent diagnostic upper gastrointestinal endoscopy for any indication at 36 centers in 10 Latin American countries, within a 3-month time frame. RESULTS: Between April and June 2016, 108 cases of eosinophilic esophagitis were evaluated. Likewise, an average of 29,253 outpatient consultations and 4,152 diagnostic upper gastrointestinal endoscopies were carried out at the 36 participating centers. The period prevalence of eosinophilic esophagitis in the population studied (n=29,253) was 3.69 cases×1,000 (95% CI: 3.04 to 4.44), and among the children that underwent routine upper gastrointestinal endoscopy (n=4,152), it was 26x1,000 (95% CI: 22.6 to 29.4). CONCLUSIONS: The general period prevalence of eosinophilic esophagitis in a group of children evaluated at 36 Latin American pediatric gastroenterology centers was 3.69×1,000, and in the children that underwent endoscopy, it was 26×1,000. There was important prevalence variability between the participating countries and centers. The present analysis is the first study conducted on the prevalence of pediatric eosinophilic esophagitis in Latin America.
Subject(s)
Eosinophilic Esophagitis/epidemiology , Adolescent , Child , Child, Preschool , Cross-Sectional Studies , Female , Gastroenterology , Hospitals, Special , Humans , Infant , Latin America/epidemiology , Male , PrevalenceABSTRACT
INTRODUCTION AND AIMS: The prevalence of functional gastrointestinal disorders (FGIDs) in Argentinean children and adolescents has not yet been studied. Our aim was to determine the prevalence of FGIDs among children and adolescents in Argentina using the Rome III diagnostic criteria. MATERIALS AND METHODS: A total of 483 children, 12-18 years of age, from 3 private schools and 3 public schools, were included in the study. Each child completed the Spanish version of the Questionnaire on Pediatric Gastrointestinal Symptoms-Rome III), which is an age-appropriate and previously validated instrument for diagnosing FGIDs according to the Rome III criteria. Sociodemographic data (age, sex, type of school, family structure and size, family history of gastrointestinal disorders) and data on stressful life events were also obtained. RESULTS: The mean age of the population studied was 15 years (standard deviation 1.74, range 12-18, 52.8% boys). Of the respondents, 229 children (47.4%) attended private school and 254 children (52.6%) attended public school. In total, 82 children (17.0%) were diagnosed with an FGID, according to the Rome III criteria. Abdominal migraine (16.4%) was the most common diagnosis, followed by irritable bowel syndrome (7.0%), functional constipation (6.4%), and aerophagia (5.6%). Girls suffered significantly more from FGIDs than boys (22.4 vs. 12.2%, P=.0032). Children attending private school had significantly more FGIDs than children in public schools (20.5 vs. 13.8%, P=.0499). CONCLUSION: FGIDs are common among Argentinean children and adolescents.
Subject(s)
Gastrointestinal Diseases/epidemiology , Adolescent , Adolescent Nutritional Physiological Phenomena , Argentina/epidemiology , Child , Female , Humans , Male , Prevalence , Surveys and QuestionnairesABSTRACT
Gastroesophageal reflux (GER) is a common finding in the newborn period, which is in general well tolerated, and tends to resolve spontaneously at about 18 months of age. However, a small number of children will present important respiratory manifestations (aspiration and apneic episodes), or increase in the manifestations of pre existing conditions (tracheomalacia, laryngomalacia), which can produce life threatning events. Ph monitoring does not completely discard the possibility of GER and the use of prokinetic drugs, in association with other drugs to protect the esophagus do not prevent serious consecuences produced by reflux to the airway. In this report six children with severe airway disease and marked GER, with no response to initial medical treatment required laparoscopic fundoplication. They have all resolved their airway disease, and are currently well. The laparocopic technique for fundoplication of small children seems to be a secure, well tolerated and definitive treatment in the hands of trained surgeons.
Subject(s)
Gastroesophageal Reflux/epidemiology , Gastroesophageal Reflux/surgery , Laparoscopy/methods , Patient Selection , Respiratory Distress Syndrome/epidemiology , Humans , Infant , Infant, Newborn , Severity of Illness IndexABSTRACT
El reflujo gastroesofágico (RGE) es una entidad de hallazgo frecuente en recién nacidos y lactantes pequeños. Por lo general es bien tolerado y constituye lo que se podría denominar una «anormalidad transitoria como parte del proceso de maduración» del recién nacido. Entre los 12 a 18 meses de edad muchos de ellos dejarán de presentarlo. Sin embargo existe un pequeño número de niños que desde el nacimiento presentan RGE importante con manifestaciones clínicas respiratorias graves (broncoaspiración, episodios de laringoespasmo) o deterioro de lesiones preexistentes (laringomalacia, traqueomalacia) que ponen en riesgo la vida. El estudio de pHmetría de 24 h no descarta la presencia de reflujo gastroesofágico y la utilización de drogas procinéticas, asociadas o no a otras que protegen al esófago, no evitan las consecuencias graves cuando el líquido refluido alcanza la vía respiratoria. Presentamos seis niños con patología respiratoria severa y diagnóstico de RGE grave que no respondieron al tratamiento médico inicial. Fueron abordados, entonces, quirúrgicamente con fundoplicatura gastroesofágica laparoscópica. Todos se encuentran actualmente libres de enfermedad. El abordaje laparoscópico en el recién nacido y lactante pequeño es, en manos entrenadas, seguro y con resultados definitivos, siendo bien tolerado y con escasa morbilidad (AU)
Gastroesophageal reflux (GER) is a common finding in the newborn period, which is in general well tolerated, and tends to resolve spontaneously at about 18 months of age. However, a small number of children will present important respiratory manifestations (aspiration and apneic episodes), or increase in the manifestations of pre existing conditions (tracheomalacia, laryngomalacia), which can produce life threatning events. Ph monitoring does not completely discard the possibility of GER and the use of prokinetic drugs, in association with other drugs to protect the esophagus do not prevent serious consecuences produced by reflux to the airway. In this report six children with severe airway disease and marked GER, with no response to initial medical treatment required laparoscopic fundoplication. They have all resolved their airway disease, and are currently well. The laparocopic technique for fundoplication of small children seems to be a secure, well tolerated and definitive treatment in the hands of trained surgeons (AU)
