40% of children with GERD misdiagnosed

DUBAI — Gastroenterologists have warned in a medical symposium here that if Gastroesophageal reflux disease (GERD), which is now becoming increasingly common among children, is not correctly treated, it could lead to serious complications such as inflammation in the esophagus, narrowing of it, ulcers and bleeding.

In a medical symposium held by AstraZeneca Gulf in coordination with the Ministry of Health (MoH) in the UAE, Dr Suleiman Nayyal, a Dubai-based Consultant Gastroenterologist, said among the group of children aged between 7 and 12 years in the UAE, as high as 40 per cent of the cases were misdiagnosed. “GERD, if mistreated, may cause Asthma. Moreover, Asthma could be combated by treating paediatric groups for GERD. We are happy to start using Esomeprazole (chemical name) developed by AstraZeneca for the treatment of GERD in children in the age group of 1-11 years. We are also prescribing this medicine to old people who cannot take pills,” the doctor said.

Dr Nayyal revealed many paediatric groups in the UAE were misdiagnosed as Asthma, allergy and other diseases, while actually it is GERD. Symptoms of this disease include cough, chest pain, flatulence and bloating. Dr Dore SP, Consultant Gastroenterologist at Al Zahra Medical Center said that recognition of GERD in the paediatric group (from 7 to 12 years old) is increasing. “Earlier, GERD symptoms used to go undetected. There has been a dramatic increase in children who are affected with the disease, compared to ten years ago.”

Prof. Dr G. Veereman, a paediatric gastroenterologist currently affiliated with the Free University Brussels and the Children’s Hospital UZ Brussels, Belgium, was present at the symposium.

“GERD affects children’s school performance, disrupts sleeping habits and restricts social activities. The significant impact on physical and mental health brings emotional consequences. Anger, frustration, anxiety and even depression have been reported as a result of GERD in children,” added Mahmoud Sabry, medical manager, AstraZeneca Gulf.

The first step to treat children with GERD is to change their lifestyle, for example, sleeping position, diet and clothing. This should help to reduce the troublesome symptoms.

Modifying diet such as restricting a child’s intake of carbonated beverages including fizzy drinks, caffeine, chocolate and spicy foods may reduce symptoms. High acid food such as citrus fruit (oranges) and tomatoes can aggravate GERD. Avoiding tight clothing that puts pressure on the stomach will also help to manage reflux disease in children.

“It can be very difficult to identify GERD symptoms in younger children since they are not always able to clearly express to their caregivers how they feel. Older children are likely to be able to better describe their symptoms. Common clinical manifestations of persistent, recurring GERD symptoms in younger children includes vomiting, constant or sudden crying, poor weight gain, recurrent ‘wet Burp, hiccup’ sounds, dysphagia, abdominal pain, heart pain and respiratory disorder,” Sabry said.

As children get older, the symptom pattern changes to become more similar to that of adults, including heartburn, acid belches, regurgitation, chronic sore throat, stomach pain and gastrointestinal discomfort. Extra esophageal symptoms such as chronic cough and Asthma can also be associated by reflux disease.

“AstraZeneca’s aim is to improve understanding of GERD in children amongst parents and healthcare professionals and ensure children are treated with the most available treatment,” Sabry said.

Khaleej Times

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