ENDOSCOPIC AND HISTOLOGICAL CORRELATION BETWEEN GASTROESOPHAGEAL REFLUX DISEASE AND FOOD ALERGY

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Background -Food allergy (FA) can be defined as an adverse health effect triggered by a specific immune response that occurs upon exposure to a particular food.In some groups of pediatric patients, FA has been related to gastroesophageal reflux, abdominal colic and constipation.Objective -This study evaluated endoscopic and histopathological findings in gastroesophageal reflux disease (GERD) and FA in a specific pediatric population seen at a private clinic in Goiânia.Methods -Findings from Upper Digestive Endoscopy (UDE) and histopathological findings from biopsies performed on patients aged zero to eighteen years old were retrospectively evaluated.The diagnosis of GERD was based on endoscopic and histological findings and graded according to Savary-Miller modified classification.The diagnosis of FA was based on histological findings, and the number of intraepithelial eosinophils was compiled.Results -474 exams were done, 10 of which were excluded and the remaining 464 (97.9%) comprised our study group.The mean age of the group was 7.7 ± 5.4 years, ranging from 4 months to 18 years of age, with an average of 7 years, 226 of whom (48.7%) were male.Endoscopic and/or histopathological findings of FA were observed in 36/464 (7.8%) of the patients (95% CI ranging from 5.6% to 10.7%).No relationship between the presence of FA and gender was found (p = 0.39).The mean age of patients with FA was 4.7 ± 3.9 years and 8.0 ± 5.5 years in those without allergies (p = 0.0003).GERD was observed in 352/464 patients (75.9%) (95% CI ranging from 71.7% to 79.6%).No relation to gender was observed (p = 0.32).The mean age of patients with GERD was 7.3 ± 5.3 years and 9.1 ± 5.6 years in those without esophagitis (p = 0.003).When the degree of esophagitis was evaluated, 279/352 (79.3%) presented findings compatible with grade I esophagitis, 66/352 (18.8%) grade II, 6/352 (1.7%) grade III and 2 (0.7%) grade IV.No relationship between the presence of GERD and FA was observed: allergy was found in 28/352 (8.0%) patients with GERD and in 8/112 (7.1%) patients without esophagitis (p = 0.8).Likewise, no relationship between the presence of GERD and FA was observed even when we evaluated patients under 5 years of age (18/153 (11.8%) and 5/34 (14.7%), p = 0.6) or under 10 years of age (25/260 (9.6%) and 7 / 72 (9.7%), p = 0.9].Although the findings of marked esophagitis (grade III and IV) was observed only in patients without FA, this difference was not statistically significant (p = 09).Conclusion -Our findings show a high prevalence of GERD (75.9%) in a pediatric population at a private clinic in Goiânia.There is an even higher frequency of findings of mild erosive esophagitis.FA was found in 36/464 (7.8%) of these patients.No relationship between GERD and the presence of FA was observed.

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