Open AccessChanging Indications for Upper Endoscopy in Children During a 20‐year Period
Author(s) -
Franciosi James P,
Fiorino Kristin,
Ruchelli Eduardo,
Shults Justine,
Spergel Jonathan,
Liacouras Chris A,
Leonard Mary
Publication year - 2010
Publication title -
journal of pediatric gastroenterology and nutrition
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.206
H-Index - 131
eISSN - 1536-4801
pISSN - 0277-2116
DOI - 10.1097/mpg.0b013e3181d67bee
Subject(s) - medicine , endoscopy , period (music) , upper endoscopy , pediatrics , general surgery , surgery , physics , acoustics
Objectives: In parallel with the increase in pediatric esophagogastroduodenoscopy (EGD) procedures since the 1970s, the incidence of disorders that require EGD for diagnosis in children has increased. The aim of this study was to identify changes in subject characteristics and endoscopic procedures during a 20‐year interval in children undergoing EGD at a single center. Patients and Methods: All of the children undergoing first EGD with biopsy in 1985, 1995, or 2005 were identified. Details of the clinical presentation and EGD were abstracted from medical records in a random sample of subjects within each time point. Results: The number of first‐time EGDs rose dramatically from 107 in 1985 to 1294 in 2005. The proportion of subjects that were younger than 1 year of age varied significantly from 13% in 1985 to 23% in 1995 and 8% in 2005 ( P < 0.001). The proportion of subjects with gastrointestinal (GI) bleeding declined from 34% to 5% during the 20‐year interval ( P < 0.001), whereas the proportion with abdominal pain increased from 23% to 43% ( P < 0.01). During the same interval, the proportion of subjects with complete EGD (biopsies from the esophagus, stomach, and duodenum) increased from 18% of EGDs in 1985 to 95% in 2005 ( P < 0.001). Conclusions: This study of children undergoing first‐time EGDs with biopsy during a 20‐year interval demonstrated significant differences in subject characteristics and endoscopy practices. The inclusion of children with less severe clinical presentation and the collection of greater numbers of biopsies per procedure may contribute to the rising incidence rates of pediatric GI disorders.