The diagnosis of gastroesophageal reflux disease in children.
OBJECTIVE
Gastroesophageal reflux disease is a common disorder affecting children worldwide. The objective of this study is to report our experience on the accuracy of tests used for the diagnosis ofgastroesophageal reflux disease with emphasis on the advantages and disadvantages of each of them.


METHODS
This study took place in the Pediatric Gastroenterology Division, Department of Pediatrics, College of Medicine and King Khalid University Hospital, Riyadh, Kingdom of Saudi Arabia, during the period of 1994 through to 1999. Results of barium meal, 24-hour esophageal pH monitoring, endoscopy, and gastrointestinal scintigraphy are analyzed and compared in children with and without gastroesophageal reflux disease.


RESULTS
One hundred and forty-four children were investigated. The diagnosis was confirmed in 85 and excluded in 59 children, who will be considered as patients without gastroesophageal reflux disease. The results of barium meal, 24 hour pH monitoring, endoscopy, and gastrointestinal scintigraphy were positive in 80%, 78%, 92%, and 70% of the patients with gastroesophageal disease. The same studies were falsely positive in 29%, 9%, 19%, and 0% of those without gastroesophageal reflux disease. Esophageal pH was the most specific diagnostic study (91%), whereas endoscopy was the most sensitive (92%) and had the best positive predictive value (95%).


CONCLUSIONS
The results of this study are similar to reports from other parts of the world. It is stressed that all procedures have important advantages and disadvantages indicating that the selection of procedures should be individualized and based on the clinical situation.
El Mouzan
Mohammad I
MI
Division of Gastroenterology, Department of Pediatrics 39, College of Medicine and King Khalid University Hospital, PO Box 7805, Riyadh 11472, Kingdom of Saudi Arabia. drmouzan@hotmail.com
Abdullah
Asaad M
AM
D001466:Barium Sulfate; D002648:Child; D002675:Child, Preschool; D016145:Endoscopy, Digestive System; D005260:Female; D005745:Gastric Acidity Determination; D005764:Gastroesophageal Reflux / Q000175:diagnosis* / Q000000981:diagnostic imaging; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D012529:Saudi Arabia; D012680:Sensitivity and Specificity; D014055:Tomography, Emission-Computed
D001466:Barium Sulfate