title: Outcomes of children after esophagogastroduodenoscopy for chronic abdominal pain.
abstract: OBJECTIVE
  Chronic abdominal pain is the most common indication for esophagogastroduodenoscopy (EGD) in children. However, little is known about the accuracy of EGD-based diagnosis or the outcomes of the patients who undergo this procedure. We examined the diagnostic yield of EGD and short-term outcomes of children who underwent this procedure for chronic abdominal pain.
  
  
  METHODS
  We conducted a prospective study of 290 children (4-18 years old; mean age, 11.9 ± 3.5 years; 93 girls) who underwent EGD for the primary indication of chronic abdominal pain (216 with at least 1 alarm feature) at a US pediatric gastroenterology referral center. We collected data on demographic features (age, sex), clinical characteristics (alarm features, Rome III criteria), and EGD results for each patient. All subjects with diagnostic lesions were followed for at least 1 year after EGD to determine short-term outcomes.
  
  
  RESULTS
  Overall, EGD provided an accurate diagnosis for 109 children (38%). Diagnoses included esophagitis (21.0%), eosinophilic gastroenteritis (4.1%), eosinophilic esophagitis (3.8%), Helicobacter pylori infection (2.0%), celiac disease (0.6%), and Crohn's disease (0.4%). Short-term outcomes were available for 81% of patients with diagnostic findings, and medical therapy was effective in approximately 67% of these children.
  
  
  CONCLUSIONS
  EGD is valuable for the diagnosis of children with abdominal pain, with a 38% diagnostic yield. EGD identified disorders for which medical therapy was effective in 67% of children during the year after diagnosis.
authors.affiliation: Section of Pediatric Gastroenterology, Hepatology and Nutrition, Baylor College of Medicine, Houston, Texas. Electronic address: kthakkar@bcm.edu.
authors.forename: Kalpesh
authors.initials: K
authors.lastname: Thakkar
authors.affiliation: Section of Pediatric Gastroenterology, Hepatology and Nutrition, Baylor College of Medicine, Houston, Texas.
authors.forename: Leon
authors.initials: L
authors.lastname: Chen
authors.affiliation: Section of Pediatric Gastroenterology, Hepatology and Nutrition, Baylor College of Medicine, Houston, Texas.
authors.forename: Mary E
authors.initials: ME
authors.lastname: Tessier
authors.affiliation: Section of Pediatric Gastroenterology, Hepatology and Nutrition, Baylor College of Medicine, Houston, Texas.
authors.forename: Mark A
authors.initials: MA
authors.lastname: Gilger
mesh_terms: D015746:Abdominal Pain / Q000209:etiology*; D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D016145:Endoscopy, Digestive System / Q000379:methods*; D005260:Female; D005767:Gastrointestinal Diseases / Q000175:diagnosis* / Q000473:pathology / Q000628:therapy; D016480:Helicobacter pylori; D006801:Humans; D008297:Male; D011446:Prospective Studies; D016896:Treatment Outcome; D014481:United States
keywords: Evaluation; Gastrointestinal Endoscopy; Management; Pediatrics
references.citation: J Pediatr. 2009 Jan;154(1):96-100
references.pmid: 18783791
references.citation: Clin Gastroenterol Hepatol. 2011 Nov;9(11):950-956.e1
references.pmid: 21806952
references.citation: Curr Gastroenterol Rep. 2005 Jun;7(3):234-9
references.pmid: 15913484
references.citation: Gastroenterology. 2008 May;134(5):1316-21
references.pmid: 18471509
references.citation: J Pediatr Gastroenterol Nutr. 2008 Aug;47(2):234-8
references.pmid: 18664881
references.citation: Gastroenterology. 2006 Apr;130(5):1527-37
references.pmid: 16678566
references.citation: J Pediatr Gastroenterol Nutr. 1996 Apr;22(3):321-5
references.pmid: 8708889
references.citation: Gastroenterol Clin North Am. 2008 Jun;37(2):333-48, v
references.pmid: 18499023
references.citation: Gastroenterology. 2007 Oct;133(4):1342-63
references.pmid: 17919504
references.citation: Clin Gastroenterol Hepatol. 2012 Oct;10(10):1066-78
references.pmid: 22728382
references.citation: Pediatr Dev Pathol. 2006 May-Jun;9(3):210-8
references.pmid: 16944979
references.citation: Clin Gastroenterol Hepatol. 2007 Oct;5(10):1175-83
references.pmid: 17686660
references.citation: Gut. 2001 Jul;49(1):29-34
references.pmid: 11413107
references.citation: Acta Paediatr. 1992 Feb;81(2):137-40
references.pmid: 1515756
references.citation: Am J Gastroenterol. 2007 Mar;102(3):654-61
references.pmid: 17222318
references.citation: J Pediatr Gastroenterol Nutr. 2001;32 Suppl 2:S1-31
references.pmid: 11525610
references.citation: Am J Gastroenterol. 2009 May;104(5):1278-95; quiz 1296
references.pmid: 19352345
references.citation: J Pediatr Gastroenterol Nutr. 2005 Mar;40(3):249-61
references.pmid: 15735476
references.citation: Best Pract Res Clin Gastroenterol. 2005 Apr;19(2):177-98
references.pmid: 15833687
references.citation: J Pediatr Gastroenterol Nutr. 2000;30 Suppl:S28-35
references.pmid: 10634296
references.citation: Aliment Pharmacol Ther. 2009 Sep 15;30(6):662-9
references.pmid: 19573168
references.citation: Dig Dis Sci. 2011 Feb;56(2):488-93
references.pmid: 20596777