DEVELOPMENT OF A MULTIDIMENSIONAL MEASURE FOR GASTROESOPHAGEAL REFLUX DISEASE IN CHILDREN (MM-GERD)

Abstract

Purpose: Gastroesophageal reflux disease (GERD) in children presents with combinations symptoms including, abdominal pain, heartburn, regurgitation and vomiting. We aimed to develop and test an age-specific instrument for measuring GERD in children Methods: We examined the responses of children participating in a validation study for a multi-dimensional measure of recurrent abdominal pain in (RAP). That measure consisted of 4 scales: a pain intensity scale (3 items), a symptoms scale (12 items), a disability scale (3 items), and a satisfaction scale (2 items). The symptoms scale was derived from 12 items that included GERD symptoms each rated from 1 to 5 (5 = very severe). We applied factor analysis to examine the different components to identify GERD symptoms. The extraction method used all 20 items of the four scales and was used to identify and reconstruct the components needed to develop a GERD-specific measure for children Results: 307 children (ages 4-17) participated. The internal consistency Cronbach's coefficient alpha) for the RAP scales were 0.75, 0.81, 0.80, and 0.78 (range 0–1) forthe pain intensity items, non-pain items, disability items and satisfaction items respectively. The 12-items of the symptoms scale were subclassified into two components; GERD symptoms (heartburn, burping, passing gas, bloating, and abdominal pain) and IBS symptoms (diarrhea, constipation/hard stool, and nausea/vomiting). The other symptoms items had correlation of 0.40 or less and were excluded. Conclusions: We have developed a multi-dimensional measure for assessing the severity of GERD symptoms in children. The measure remains to be validated in order to serve as an evaluative measure for treatment in clinical trials.