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Contribution of Histology to the Diagnosis of GER

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Gastroesophageal Reflux in Children

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Abstract

The presence of endoscopically visible breaks in the mucosa at/or immediately above the gastroesophageal junction is a sign of reflux esophagitis, but the presence of endoscopically normal esophageal mucosa does not exclude a diagnosis of non-erosive reflux disease. Reflux esophagitis may affect the mucosa in a patchy fashion, and, as such, multiple biopsies are warranted to document histologic abnormalities. At least two biopsies at 2–3 cm above the gastroesophageal junction appear to be the most relevant to identify esophagus lesions. In infants and children, the correlation between histopathologic features, clinical symptoms, and pH monitoring is poor, whereas basal esophageal impedance and contractile segment impedance measurements appear to be predictive of peptic esophagitis.

In the context of gastroesophageal reflux, the roles of esophageal biopsies in children are to rule out other diagnosis such as eosinophilic esophagitis, Crohn’s disease, Barrett’s esophagus, or infection, to screen for Barrett’s esophagus, and to follow complications related to specific pediatric populations such as esophageal atresia, neurologic impairment, or cystic fibrosis.

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Acknowledgment

We thank Kristen Calabro, MD for editing the manuscript.

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Authors and Affiliations

  1. Division of Pediatric Gastroenterology, Hepatology and Nutrition, CHU Sainte-Justine, Montréal, QC, Canada

    Chloé Girard & Christophe Faure

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  1. Chloé Girard
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  2. Christophe Faure
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Correspondence to Christophe Faure .

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  1. Vrije Universitiet Brussel (VUB), UZ Brussel KidZ Health Castle, Brussels, Belgium

    Yvan Vandenplas

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Girard, C., Faure, C. (2022). Contribution of Histology to the Diagnosis of GER. In: Vandenplas, Y. (eds) Gastroesophageal Reflux in Children. Springer, Cham. https://doi.org/10.1007/978-3-030-99067-1_17

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  • DOI: https://doi.org/10.1007/978-3-030-99067-1_17

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