Goldani Helena As, Nunes Daltro La, Ferreira Cristina T
Helena AS Goldani, Daltro LA Nunes, Cristina T Ferreira, Department of Pediatrics and Gastroenterology Unit, Hospital de Clinicas de Porto Alegre, Faculdade de Medicina da Universidade Federal do Rio Grande do Sul, 90035-903 Porto Alegre-RS, Brazil.
World J Gastrointest Endosc. 2012 Aug 16;4(8):339-46. doi: 10.4253/wjge.v4.i8.339.
Gastroesophageal reflux disease (GERD) is a growing problem in the pediatric population and recent advances in diagnostics and therapeutics have improved their management, particularly the use of esophago-gastroduodenoscopy (EGD). Most of the current knowledge is derived from studies in adults; however there are distinct features between infant onset and adult onset GERD. Children are not just little adults and attention must be given to the stages of growth and development and how these stages impact the disease management. Although there is a lack of a gold standard test to diagnose GERD in children, EGD with biopsy is essential to assess the type and severity of tissue damage. To date, the role of endoscopy in adults and children has been to assess the extent of esophagitis and detect metaplastic changes complicating GERD; however the current knowledge points another role for the EGD with biopsy that is to rule out other potential causes of esophagitis in patients with GERD symptoms such as eosinophilic esophagitis. This review highlights special considerations about the role of EGD in the management of children with GERD.
胃食管反流病（GERD）在儿科人群中是一个日益严重的问题，诊断和治疗方面的最新进展改善了对其的管理，尤其是食管胃十二指肠镜检查（EGD）的应用。目前的大部分知识来自于对成人的研究；然而，婴儿期发病的GERD和成人期发病的GERD有明显的特征差异。儿童并非缩小版的成人，必须关注生长发育阶段以及这些阶段如何影响疾病管理。尽管缺乏诊断儿童GERD的金标准检测方法，但EGD活检对于评估组织损伤的类型和严重程度至关重要。迄今为止，内镜检查在成人和儿童中的作用一直是评估食管炎的程度并检测GERD并发的化生改变；然而，目前的知识表明EGD活检还有另一个作用，即排除有GERD症状的患者中食管炎的其他潜在病因，如嗜酸性粒细胞性食管炎。本综述重点介绍了关于EGD在GERD儿童管理中的作用的特殊考虑因素。
