Abstract
Currently, there are inconsistencies in the recommendations of when to obtain an esophagogastroduodenoscopy (EGD) in children with feeding difficulties. The aim of our study was to identify EGD findings in patients presenting to a large, outpatient feeding program. Additionally, we investigated the presence of any relationship between abnormal pathology seen on biopsies (inflammation) and symptoms of feeding intolerance such as vomiting, gagging, retching, or abdominal pain. Retrospective analysis of electronic medical records (EMRs) was conducted for all new patients aged 0–17 years presenting to the Multidisciplinary Feeding Clinic. Three hundred and thirty patients (50.2%) had an EGD with complete biopsies. Of these 330 patients, biopsies revealed esophagitis in 40%, gastritis in 33.6%, and duodenitis in 15.2%. Overall, 61.21% had an abnormal pathology in at least one site. We found that children with feeding disorders commonly have esophagitis, gastritis, and/or duodenitis and that symptoms are poor predictors of pathology. This study underscores the importance of gastrointestinal evaluation as part of a multidisciplinary evaluation in patients with feeding difficulties.
Highlights
Feeding difficulties (FDs) are present in 50% of children with normal development and 80% of children with developmental problems, highlighting the prevalence of these conditions and the need for effective diagnostics and treatment [1]
Six hundred and sixty-three patients were seen for evaluation in the Multidisciplinary Feeding
Five patients were removed from the study: one patient did not present to the clinic appointment, one was not seen in the Multidisciplinary Feeding Clinic, and three were found to have duplicate medical record numbers
Summary
Feeding difficulties (FDs) are present in 50% of children with normal development and 80% of children with developmental problems, highlighting the prevalence of these conditions and the need for effective diagnostics and treatment [1]. FDs have been classified into one of two dichotomies: organic or non-organic. This classification system is not all-encompassing as more than one system is often disrupted. To perform a complete workup, Goday et al recommended that FDs require a comprehensive assessment due to the involvement of four domains: medical, nutritional, feeding skill, and psychosocial dysfunction [2]. The first step of the feeding assessment should be to present a comprehensive history
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