Endoscopy and biopsy in gastroesophageal reflux in infants and children.

The clinical features of abnormal gastroesophageal reflux in infants and children extend beyond repeated vomiting and include dysphagia, pain, bleeding, failure to thrive, esophageal stricture, and recurrent respiratory symptoms including aspiration pneumonitis and cyanotic attacks. The unreliability of the traditional barium swallow examination as a diagnostic test is well known. This study reports the results of endoscopic assessment and esophageal biopsy in 100 infants and children and relates them to the clinical findings and the changes in the contrast esophagogram. The results show that further valuable diagnostic information can be gained from endoscopic examination of the esophageal mucosa, especially when there is esophagitis with ulceration, bleeding, or stricture. Endoscopic biopsies are useful to confirm the presence of esophagitis but biopsies alone do not give absolute diagnostic information.