Gastroesophageal Reflux in Children of Preschool and School Age

Background: Gastroesophageal reflux disease (GERD) is a multifactorial disease and caused gastroesophageal reflux (GER). GER means the involuntary casting of gastric or gastrointestinal contents into the esophagus, which is accompanied by the entry into the esophagus of unusual contents that can cause physico-chemical damage to the mucous membrane.

Objective: To study the significance of examination in assessing morphological changes in children with GERD.
Materials and methods. A retrospective clinical and morphological analysis of medical records and conclusions of biopsies was carried out from 2018 to 2019.

Results: We enrolled 100 children with a clinical diagnosis of GERD. In 53% of cases, GERD was combined with pathology or dysfunction of the biliary tract, in 18% of cases with abnormal forms of the gallbladder. For a more accurate clinical and morphological analysis, all cases were divided into three age groups: preschool (10% of cases), junior school (30%), adolescent children (60% of cases). All patients underwent endoscopy with examination of the esophagus, stomach and duodenum. It should be noted that targeted esophageal biopsy was performed only in 65% of cases. However, examination of a biopsy of the esophagus in all cases revealed morphological changes: metaplasia of the esophagus (26% of cases), hyperplasia of stratified squamous epithelium with vacuolar degeneration of cells (26%), focal tissue dysplasia of the esophageal epithelium in the outcome of chronic esophagitis (13%), acute erosive esophagitis (8%).

Conclusion: The examination of a biopsy of the esophagus is one of the methods for diagnosing severe morphological changes (dysplasia and metaplasia), timely treatment can prevent the development of cancer. Therefore, all patients suffering from GERD should be recommended EGD with a mandatory biopsy of the esophagus diagnosis, for the timely treatment of such changes.