| Impact of endoscopy on management of chronic abdominal pain in children. | |
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MedLine Citation:
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PMID: 20596777 Owner: NLM Status: In-Data-Review |
Abstract/OtherAbstract:
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BACKGROUND: Endoscopy is performed frequently in children with chronic abdominal pain (CAP), but its impact on clinical management is unclear. AIMS: We aimed to examine the frequency of changes in immediate medical management resulting from endoscopy with biopsy evaluating CAP in children. METHODS: We conducted a prospective cross-sectional study to assess the frequency and determinants of management change in children who underwent endoscopy for evaluation of chronic abdominal pain. Patients were screened prior to undergoing endoscopy according to inclusion criteria. Each endoscopist was contacted prior to performing endoscopy and recorded a management plan if endoscopy could not be performed. These responses were compared with management recommendations by the same physician after the endoscopy and review of histopathology. RESULTS: We analyzed 92 endoscopic procedures [63 esophagogastroduodenoscopies (EGDs) and 29 EGD/colonoscopy] performed in 92 children (mean age 11.6 years) with CAP. Overall, gastroenterologists changed management plans post endoscopy in 61 (66.3%) patients. In 46 (75%) of these cases, management was changed as a direct result of endoscopic or histologic findings. Overall, management changes included: reassurance in 17 cases, dietary changes in 6 cases, proton pump inhibitor (PPI) trial in 11 cases, antispasmodic/anticholinergic medication trials in 4 cases, and food allergy testing in 4 cases. No significant association was found between management changes and type of histologic findings or presence of alarm symptoms. CONCLUSIONS: The overall rate of management change after endoscopic evaluation in children with CAP was approximately 66% (61/92). Management outcome was not associated with type of histologic findings. |
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Authors:
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Kalpesh Thakkar; Faith Dorsey; Mark A Gilger |
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Publication Detail:
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Type: Journal Article Date: 2010-07-02 |
Journal Detail:
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Title: Digestive diseases and sciences Volume: 56 ISSN: 1573-2568 ISO Abbreviation: Dig. Dis. Sci. Publication Date: 2011 Feb |
Date Detail:
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Created Date: 2011-01-28 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 7902782 Medline TA: Dig Dis Sci Country: United States |
Other Details:
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Languages: eng Pagination: 488-93 Citation Subset: AIM; IM |
Affiliation:
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The Section of Pediatric Gastroenterology, Hepatology and Nutrition at Baylor College of Medicine, 6621 Fannin St CCC 1010, Houston, TX, 77030, USA, kthakkar@bcm.tmc.edu. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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