LAUSR

Background In recent years, GerdQ (Gastro-esophageal reflux disease Questionnaire) had been used in adults (R. Jones, J. Den, N. Vakil et al), but it has not been used in children before. The objective is to determine the validity of the GerdQ questionnaire for the diagnosis of gastro-esophageal reflux disease (GERD) in children with symptoms suggestive of GERD. Methods 63 patients aged 12–17 years with gastroenterological complaints were examined. At first the patients answered GerdQ questions, and then they underwent pH-metry and esophagofibrogastroscopy. According to the developers of the questionnaire, with a score of 8 or more, the likelihood of GERD is high, and 7 and lower is unlikely Results The following data were obtained from the questionnaire: 0–2 points - 4 patients (6.4%), 3–7 points - 46 (73.0%), 8–10 points - 11 (17.4%), 11–18 points - 2 patients (3.2%). After instrumental examination among 13 patients with scores ≥8 GERD was diagnosed in 9 (69.2%), among 50 children with scores <8 GERD was excluded in 48 (96%). The sensitivity of the GerdQ questionnaire in children was 69.2% (95% CI: 53–76), specificity - 96% (95% CI: 71–97), which allows recommending it in a wide practice. Patients with mild complaints may be prescribed a trial treatment with proton pump inhibitors already at the stage of primary treatment, without the use of additional instrumental diagnostic methods. However, this approach is fraught with certain difficulties associated with a subjective assessment of complaints, both by the patient and by the doctor. For example, patients with severe erosive-ulcerative lesions, metaplasia and dysplasia of the esophageal mucosa may have almost no clinical symptoms, whereas in other cases the abundance of the most diverse complaints actively presented by the patient is not accompanied by endoscopic changes in the mucous lining. In children, the frequency of metaplasia and dysplasia is not so great, although its significance should not be minimized. A reasonable combination of questionnaire and instrumental examination seems reasonable. Conclusions GerdQ is a useful complementary method for the diagnosis of GERD in children. It could reduce the need for pH-metry and esophagofibrogastroscopy.