PMID- 20596777
OWN - NLM
STAT- MEDLINE
DCOM- 20110311
LR  - 20211020
IS  - 1573-2568 (Electronic)
IS  - 0163-2116 (Linking)
VI  - 56
IP  - 2
DP  - 2011 Feb
TI  - Impact of endoscopy on management of chronic abdominal pain in children.
PG  - 488-93
LID - 10.1007/s10620-010-1315-1 [doi]
AB  - 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.
FAU - Thakkar, Kalpesh
AU  - Thakkar K
AD  - The Section of Pediatric Gastroenterology, Hepatology and Nutrition at Baylor 
      College of Medicine, Houston, TX 77030, USA. kthakkar@bcm.tmc.edu
FAU - Dorsey, Faith
AU  - Dorsey F
FAU - Gilger, Mark A
AU  - Gilger MA
LA  - eng
PT  - Journal Article
DEP - 20100702
PL  - United States
TA  - Dig Dis Sci
JT  - Digestive diseases and sciences
JID - 7902782
SB  - IM
MH  - Abdominal Pain/*diagnosis
MH  - Adolescent
MH  - Child
MH  - Child, Preschool
MH  - Chronic Disease
MH  - Cross-Sectional Studies
MH  - *Endoscopy, Gastrointestinal
MH  - Gastrointestinal Diseases/*diagnosis
MH  - Humans
EDAT- 2010/07/03 06:00
MHDA- 2011/03/12 06:00
CRDT- 2010/07/03 06:00
PHST- 2010/04/14 00:00 [received]
PHST- 2010/06/14 00:00 [accepted]
PHST- 2010/07/03 06:00 [entrez]
PHST- 2010/07/03 06:00 [pubmed]
PHST- 2011/03/12 06:00 [medline]
AID - 10.1007/s10620-010-1315-1 [doi]
PST - ppublish
SO  - Dig Dis Sci. 2011 Feb;56(2):488-93. doi: 10.1007/s10620-010-1315-1. Epub 2010 Jul 
      2.