Symptoms of acid-peptic disease in children.

Esophagogastroduodenoscopy (EGD) is a useful procedure for the evaluation of gastrointestinal disease in pediatric patients. Indications for EGD in children are similar to those for adults. However, symptoms of acid-peptic disease reported by children may differ from those expressed by adults. Therefore, we sought to identify symptoms associated with acid-peptic disease in pediatric patients. The medical records of 114 children having EGD with biopsy were reviewed. The diagnosis, which included esophagitis, gastritis, duodenitis, ulcer, or normal, was based on histologic findings. Six symptoms correlated significantly with acid-peptic disease: epigastric pain, nocturnal pain, postprandial pain, water brash, weight loss, and a family history of peptic ulcer disease. Epigastric pain and nocturnal pain are the most sensitive symptoms of acid-peptic disease in pediatric patients. Fecal occult blood and hematemesis, although specific, are not sensitive indicators of acid-peptic disease in children.