To determine the prevalence of esophageal symptoms and associated symptoms of gastroesophageal reflux symptoms in 14-18 year-old high school students and the percentage of symptomatic adolescents who saw a physician or received medications.
A cross-sectional questionnaire administered to students at two high schools.
1,286 completed questionnaires were analyzed. The study sample consisted of 57% Caucasians and 57% males, with a mean age of 15.7 (+/-1.3) years.
No intervention was used. Participants completed questionnaires only.
714 students (56%) reported at least one esophageal or respiratory symptom. Esophageal symptoms reported were: heartburn (22%), regurgitation (21%), and dysphagia (15%). Respiratory symptoms reported were: shortness of breath (24%), wheezing (20%), and cough (18%). Students with at least one esophageal symptom were more likely to experience at least one respiratory symptom than were students with no esophageal symptoms (52% vs. 25%; p < 0.001). Cigarette, alcohol, and non-steroidal anti-inflammatory drug use were risk factors for both respiratory and esophageal symptoms. Of those experiencing one or more of these symptoms, 4% reported that the symptoms affected their daily activities, 23% visited a physician, and 25% took medication in the past year.
Esophageal symptoms of gastroesophageal reflux are frequent in adolescents. Fewer than 25% of students with gastroesophageal reflux symptoms consulted a physician and/or took medications.
"Heartburn and regurgitation are typical symptoms in adults and have high specificity for GERD.3 Many experts believe that these symptoms can be considered indicators of GERD in children older than eight years and in adolescents.4 However, in infants and preschool children, heartburn, regurgitation/vomiting, refusing feeding, excessive crying, and abdominal pain are often associated with GERD, but these symptoms lack specificity.5 "
[Show abstract][Hide abstract] ABSTRACT: To review the literature on the treatment of gastroesophageal reflux disease (GERD) with emphasis on proton pump inhibitors (PPIs), particularly on delayed-release esomeprazole, and to identify properties and adverse effects of PPIs observed in the treatment of GERD in children and adolescents.
Electronic search of PubMed/Medline and Cochrane Collaboration databases, and of abstracts on DDW, NASPGHAN, and ESPGHAN. We focused on controlled and randomized studies published since 2000 and identified reviews that presented a consensual position, and directives published within the last 10 years.
PPIs are considered better antisecretory agents than H(2)-receptor antagonists. Although all PPIs are similar, they are not identical in their pharmacologic properties. For example, the acid-suppressive effect of esomeprazole, the S-isomer of omeprazole, persists for more than 16 hours after administration of the morning dose. Therefore, it can control acidity after night meals better than a single dose of omeprazole. Moreover, the onset of the suppressive effect of esomeprazole is faster. It achieves acid inhibition faster than other PPIs.
Currently, the mainstream treatment for GERD in children is a PPI. Although PPIs are safe drugs, effective in healing erosive esophagitis, and in relieving symptoms, studies with esomeprazole have shown that this drug has as powerful an ability to inhibit acid secretion as omeprazole. It also seems that some pharmacologic properties of esomeprazole are actually better for the treatment of GERD.
[Show abstract][Hide abstract] ABSTRACT: An original, fully analytical non-quasi-static (NQS) small-signal model of the MOS transistor is proposed for analysis and simulation of radio and microwave frequency circuits. We report results of frequency-domain analysis, the main features and experimental verification of the novel NQS four-terminal model derived in the time-domain (Kordalski, Int. Conf. on Signals and Electron. Sys., 2000). The carrier velocity saturation effect is taken into account in this model. The model is computationally efficient, physically consistent and can be applied to an arbitrary configuration of device operation.
Circuits and Systems for Communications, 2002. Proceedings. ICCSC '02. 1st IEEE International Conference on; 02/2002
[Show abstract][Hide abstract] ABSTRACT: To develop an international consensus on the definition of gastroesophageal reflux disease (GERD) in the pediatric population.
Using the Delphi process, a set of statements was developed and voted on by an international panel of eight pediatric gastroenterologists. Statements were based on systematic literature searches using Medline, EMBASE, and CINAHL. Voting was conducted using a six-point scale, with consensus defined, a priori, as agreed by 75% of the group. The strength of each statement was assessed using the GRADE system.
There were four rounds of voting. In the final vote, consensus was reached on 98% of the 59 statements. In this vote, 95% of the statements were accepted by seven of eight voters. Consensus items of particular note were: (i) GERD is present when reflux of gastric contents causes troublesome symptoms and/or complications, but this definition is complicated by unreliable reporting of symptoms in children under the age of approximately 8 years; (ii) histology has limited use in establishing or excluding a diagnosis of GERD; its primary role is to exclude other conditions; (iii) Barrett's esophagus should be defined as esophageal metaplasia that is intestinal metaplasia positive or negative; and (iv) extraesophageal conditions may be associated with GERD, but for most of these conditions causality remains to be established.
The consensus statements that comprise the Definition of GERD in the Pediatric Population were developed through a rigorous process. These statements are intended to be used for the development of future clinical practice guidelines and as a basis for clinical trials.
The American Journal of Gastroenterology 05/2009; 104(5):1278-95; quiz 1296. DOI:10.1038/ajg.2009.129 · 10.76 Impact Factor
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