본문 바로가기
KERD
논문KCI 등재

Association between Minimal Change Esophagitis and Gastric Dysmotility: A Single-Center Electrogastrography and Endoscopy Study in Children

1

조회

0

다운로드

0

인용

0

참고문헌

키워드

주제분류소아과학

초록

Purpose: Minimal change esophagitis (MCE) is a reflux disease without mucosal breaks, known to be partially asso-ciated with abnormal gastric motor function. Electrogastrography (EGG) is commonly applied to assess gastric motor function in a noninvasive fashion. We aimed to determine the relationship between MCE and gastric myoelectrical activity (GME) recorded on EGG in children. Methods: We retrospectively assessed the records of 157 children without underlying disease who underwent both EGG and upper gastrointestinal endoscopy at Gachon University Gil Medical Center between January 2010 and June 2015. The children were stratified according to the appearance of the esophagus (normal vs. MCE). Between-group differences in EGG parameters and their correlation with each MCE finding were statistically analyzed. Results: Only the power ratio, one of the EGG parameters analyzed, differed significantly between the two groups (MCE, 1.68±3.37 vs. normal, 0.76±1.06; p<0.05), whereas the other parameters, such as dominant frequency, domi-nant power, and the ratio of abnormal rhythm, showed no differences. Among children with MCE, significant correla-tions were noted between erythema and power ratio (p<0.05), friability and postprandial dominant frequency (p<0.05), and edema and/or accentuation of mucosal folds and pre-prandial frequency (p<0.05). Helicobacter pylori infection correlated with postprandial arrhythmia (MCE, 33.59±15.52 vs. normal, 28.10±17.23; p<0.05). EGG parameters did not differ between children with normal esophagus and those with biopsy-proven chronic esophagitis.Conclusion: In children with MCE, gastric dysmotility may affect the development of MCE, manifesting as EGG abnormalities. H. pylori infection may also affect GME. However, larger prospective investigations are needed to confirm these findings.

Abstract

Purpose: Minimal change esophagitis (MCE) is a reflux disease without mucosal breaks, known to be partially asso-ciated with abnormal gastric motor function. Electrogastrography (EGG) is commonly applied to assess gastric motor function in a noninvasive fashion. We aimed to determine the relationship between MCE and gastric myoelectrical activity (GME) recorded on EGG in children. Methods: We retrospectively assessed the records of 157 children without underlying disease who underwent both EGG and upper gastrointestinal endoscopy at Gachon University Gil Medical Center between January 2010 and June 2015. The children were stratified according to the appearance of the esophagus (normal vs. MCE). Between-group differences in EGG parameters and their correlation with each MCE finding were statistically analyzed. Results: Only the power ratio, one of the EGG parameters analyzed, differed significantly between the two groups (MCE, 1.68±3.37 vs. normal, 0.76±1.06; p<0.05), whereas the other parameters, such as dominant frequency, domi-nant power, and the ratio of abnormal rhythm, showed no differences. Among children with MCE, significant correla-tions were noted between erythema and power ratio (p<0.05), friability and postprandial dominant frequency (p<0.05), and edema and/or accentuation of mucosal folds and pre-prandial frequency (p<0.05). Helicobacter pylori infection correlated with postprandial arrhythmia (MCE, 33.59±15.52 vs. normal, 28.10±17.23; p<0.05). EGG parameters did not differ between children with normal esophagus and those with biopsy-proven chronic esophagitis.Conclusion: In children with MCE, gastric dysmotility may affect the development of MCE, manifesting as EGG abnormalities. H. pylori infection may also affect GME. However, larger prospective investigations are needed to confirm these findings.

참고문헌 (26)

  1. Vandenplas Y, "Pediatric gastroesophageal reflux clinical practice guidelines: joint recommendations of the North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition (NASPGHAN) and the European Society for Pediatric Gastroenterology, Hepatology, and Nutrition (ESPGHAN)", J Pediatr Gastroenterol Nutr, 49, pp.498~547 (2009)[DOI]
  2. Onyeador N, "Paediatric gastroesophageal reflux clinical practice guidelines", Arch Dis Child Educ Pract Ed, 99, pp.190~193 (2014)[DOI]
  3. Dent J, "Epidemiology of gastro-oesophageal reflux disease: a systematic review", Gut, 54, pp.710~717 (2005)[DOI]
  4. Okimoto E, "Prevalence of gastroesophageal reflux disease in children, adults, and elderly in the same community", J Gastroenterol Hepatol, 30, pp.1140~1146 (2015)[DOI]
  5. 권현정, "복통이 있는 소아청소년에서 식도염의 유병률과 위험인자", Pediatric Gastroenterology, Hepatology & Nutrition, 11(2), pp.103~109 (2008), 대한소아소화기영양학회
  6. Nakamura T, "Minimal change oesophagitis: a disease with characteristic differences to erosive oesophagitis", Aliment Pharmacol Ther, 21(Suppl 2), pp.19~26 (2005)
  7. Hoshihara Y, "Endoscopic findings of GERD", Nihon Rinsho, 62, pp.1459~1464 (2004)
  8. Lundell LR, "Endoscopic assessment of oesophagitis: clinical and functional correlates and further validation of the Los Angeles classification", Gut, 45, pp.172~180 (1999)[DOI]
  9. 류한승, "미세변화 식도염", 대한소화기학회지, 67(1), pp.4~7 (2016), 대한소화기학회
  10. Kudara N, "Gastric emptying and electrogastrography in reflux esophagitis: results in patients showing endoscopically erosive esophagitis under proton pump inhibitor therapy", Hepatogastroenterology, 57, pp.772~776 (2010)
  11. Martinucci I, "Esophageal motility abnormalities in gastroesophageal reflux disease", World J Gastrointest Pharmacol Ther, 5, pp.86~96 (2014)[DOI]
  12. Chang FY, "Electrogastrography: basic knowledge, recording, processing and its clinical applications", J Gastroenterol Hepatol, 20, pp.502~516 (2005)[DOI]
  13. Jamer T, "Multichannel electrogastrography in pediatrics-progress in standardisation and clinical application", Dev Period Med, 18, pp.367~373 (2014)
  14. Kamiya T, "Impaired gastric motility and its relationship to reflux symptoms in patients with nonerosive gastroesophageal reflux disease", J Gastroenterol, 44, pp.183~189 (2009)[DOI]
  15. Cucchiara S, "Gastric electrical dysrhythmias and delayed gastric emptying in gastroesophageal reflux disease", Am J Gastroenterol, 92, pp.1103~1108 (1997)
  16. Kim JH, "Is minimal change esophagitis really part of the spectrum of endoscopic findings of gastroesophageal reflux disease? A prospective, multicenter study", Endoscopy, 43, pp.190~195 (2011)[DOI]
  17. Jieyun Yin, "Electrogastrography: Methodology, Validation and Applications", Journal of Neurogastroenterology and Motility (JNM), 19(1), pp.5~17 (2013), 대한소화기 기능성질환∙운동학회
  18. Shin JM, "Pharmacology of proton pump inhibitors", Curr Gastroenterol Rep, 10, pp.528~534 (2008)[DOI]
  19. Shimada Y, "Electrogastrographic power ratio in humans is not related to changes in antrum-skin distance but to antral motility", J Gastroenterol, 33, pp.310~317 (1998)[DOI]
  20. Chang FY, "Stomach myoelectrical response of patients with gastroesophageal reflux disease receiving omeprazole treatment", J Gastroenterol Hepatol, 18, pp.1399~1406 (2003)[DOI]
  21. Sook-Young Han, "Incomplete Relationship between Dominant Power of Electrogastrography and Gastric Myoelectrical Activity in patients with Functional Dyspepsia", 대한한의학회지, 24(4), pp.92~101 (2003), 대한한의학회
  22. Armstrong D, "The endoscopic assessment of esophagitis: a progress report on observer agreement", Gastroenterology, 111, pp.85~92 (1996)[DOI]
  23. Takubo K, "Is there a set of histologic changes that are invariably reflux associated?", Arch Pathol Lab Med, 129, pp.159~163 (2005)
  24. Eren M, "pylori infection on gastrin, ghrelin, motilin, and gastroesophageal reflux", Turk J Gastroenterol, 26, pp.367~372 (2015)[DOI]
  25. Lupu VV, "Helicobacter pylori infection and gastroesophageal reflux in children", Dis Esophagus, 29, pp.1007~1012 (2016)[DOI]
  26. Thor P, "Dysfunction in gastric myoelectric and motor activity in Helicobacter pylori positive gastritis patients with non-ulcer dyspesia", J Physiol Pharmacol, 47, pp.469~476 (1996)

관련 논문AI추천

Esophageal Bolus Transit in Newborns with Gastroesophageal Reflux Disease Symptoms: A Multichannel Intraluminal Impedance StudyAlessandra Coscia, Elena Maggiora, Emanuela Locatelli, Enrico Bertino, Flavia Indrio, Francesco Cresi, Stefania Alfonsina Liguori대한소아소화기영양학회 · Pediatric Gastroenterology, Hepatology & Nutrition2015 · 제18권 제4호Is the Diagnostic Trial with Proton Pump Inhibitors Reasonable for School Age Children with Gastroesophageal Reflux Symptoms?Hyunju Lee, Hyun Sik Kang, Jaeeun Yang, Jae Hong Choi, Jieon Lee, Juyeon Lee, Ki-Soo Kang, Kyoung Hee Han, Seung Hyo Kim, Yoon-Joo Kim, Young Mee Youn대한소아소화기영양학회 · Pediatric Gastroenterology, Hepatology & Nutrition2019 · 제22권 제6호The Role of Combined Multichannel Intraluminal Impedance-pH Monitoring in Infants with Brief, Resolved, Unexplained EventsIrena Ivković Jureković, Iva Hojsak, Ivan Pavić, Jadranka Sekelj Fureš, Maja Bosanac, Marta Navratil대한소아소화기영양학회 · Pediatric Gastroenterology, Hepatology & Nutrition2021 · 제24권 제3호복통이 있는 소아청소년에서 식도염의 유병률과 위험인자류일, 차한, 권현정, 손동우, 이대용, 조강호대한소아소화기영양학회 · Pediatric Gastroenterology, Hepatology & Nutrition2008 · 제11권 제2호Prevalence and Epidemiological Characteristics of Endoscopically Proven Reflux Esophagitis in Children in Korea강빈, 김경아, 김혜성, 양아람, 최연호, 최재영대한소아소화기영양학회 · Pediatric Gastroenterology, Hepatology & Nutrition2017 · 제20권 제3호Clinical Manifestations of Eosinophilic Esophagitis in Children and Adolescents: A Single-Center, Matched Case-Control Study류일, 차한, Ji Hyeon Roh대한소아소화기영양학회 · Pediatric Gastroenterology, Hepatology & Nutrition2020 · 제23권 제4호

이 간행물의 다른 논문 (10건)