Esophageal, Gastric, and Duodenal Histologic Findings in Patients with Feeding Difficulties

Nutrients. 2020 Sep 15;12(9):2822. doi: 10.3390/nu12092822.


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.

Keywords: EGD; evaluation; feeding; gastrointestinal; pathology.

MeSH terms

  • Abdominal Pain / etiology
  • Adolescent
  • Child
  • Child, Preschool
  • Duodenitis / complications
  • Duodenitis / diagnosis*
  • Duodenitis / physiopathology
  • Endoscopy, Digestive System / methods*
  • Esophagitis / complications
  • Esophagitis / diagnosis*
  • Esophagitis / physiopathology
  • Female
  • Gastritis / complications
  • Gastritis / diagnosis*
  • Gastritis / physiopathology
  • Humans
  • Infant
  • Male
  • Retrospective Studies
  • Vomiting / etiology