J Korean Med Sci.  2016 Feb;31(2):270-274. 10.3346/jkms.2016.31.2.270.

Screening and Identifying Erosive Esophagitis in Children with Non-cardiac Chest Pain

• Park HW
• Choi YJ
• Jeong SJ

• KMID: 2360052
• DOI: http://doi.org/10.3346/jkms.2016.31.2.270

Abstract

Non-cardiac chest pain is a common disorder that leads to costly evaluations to distinguish it from cardiac pain. The present study aimed to clarify the clinical characteristics of erosive esophagitis in children with non-cardiac chest pain. Ninety nine patients (mean age, 9.55 ± 2.95 years, 49 girls) with non-cardiac chest pain were enrolled. Patients were classified into two groups: erosive esophagitis and non-erosive esophagitis-related non-cardiac chest pain by esophagogastroduodenoscopy. Children in the erosive esophagitis-related non-cardiac chest pain group were significantly older (10.95 ± 2.54 years vs. 8.52 ± 2.83 years). Multivariate logistic regression analysis identified the following predictors of gastroesophageal reflux: chest pain related to sleep (odds ratio = 18.05, 95% confidence interval: 3.18-102.49); unfavorable dietary habits (odds ratio = 7.11, 95% confidence interval: 1.53-32.87); chest pain related to food (odds ratio = 5.09, 95% confidence interval: 1.37-18.86); epigastric pain (odds ratio = 3.73, 95% confidence interval: 1.12-12.33); and nausea, vomiting, and/or regurgitation (odds ratio = 4.35, 95% confidence interval: 1.22-15.54). Gastroesophageal reflux disease should be considered first in children with non-cardiac chest pain. Children with gastroesophageal reflux disease should receive medical treatment and lifestyle modifications.

Keyword

Chest Pain; Erosive Esophagitis; Gastroesophageal Reflux; Diet; Pediatrics

MeSH Terms

Adolescent
Chest Pain
Child
Child, Preschool
Demography
Endoscopy, Digestive System
Esophagitis/*diagnosis
Female
Gastroesophageal Reflux/diagnosis
Humans
Male
Odds Ratio
Retrospective Studies
Risk Factors
Sleep
Surveys and Questionnaires

Figure

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  Fig. 1 Flow chart of the study population. CP, chest pain; EE, erosive esophagitis; NCCP, non-cardiac chest pain.

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  Fig. 2 Characteristics of patients’ chest pain. Chest pain related to food or sleep is significantly more frequent in the erosive esophagitis (EE)-related non-cardiac chest pain (NCCP) group (P < 0.05). However, chest pain related to exercise is not significantly different between groups.

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