May cardia mucosa histopathology aid in the diagnosis of gastroesophageal reflux disease in children?

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Introduction: Gastroesophageal reflux disease (GERD) is a common diagnosis in children referred to pediatricians. This disease is diagnosed clinically based on the patient’s signs and symptoms; however, there are endoscopic and pathological evaluations to diagnose this disease too. This study evaluated the relationship between GERD and cardia mucosa histopathology in children under six years old. Objectives: Studies on adults with GERD had shown different cardia histopathology related to GERD, and this relationship in children was less evaluated. According to this and the high prevalence of GERD in children. Patients and Methods: Children who were a candidate for endoscopy were selected. Endoscopy was conducted for each participant and biopsies from the cardia area were obtained. In the recovery room, Infant Gastroesophageal Reflux Disease Questionnaire-Revised (IGERQ-R) was completed by children’s parents for identifying GERD in children. Then the relation between the presence of GERD and histopathology of the cardia area was assessed. Results: In this study, 80 children with a mean age of 33.8±20.7 months were evaluated, while 53.8% of them were male. The histopathology finding in participants with GERD was 48.1% oxyntic mucosa and 51.9% oxyntocardiac mucosa with lymphoid aggregation. This histopathology in patients without GERD was 67.9% oxyntic mucosa and 32.1% oxyntocardiac mucosa with lymphoid accumulation. There was a significant relationship between GERD and cardia mucosa type (P=0.043). Conclusion: Children with GERD had different cardia histopathology compared with those without reflux disease.

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