Spectrum of esophagitis in children with cerebral palsy - A clinical, endoscopic, and histopathological correlation

Abstract

Background: Gastrointestinal disease is frequent in children with severe neurological impairment and developmental disability. Dysphagia may worsen due to concurrent gastroesophageal reflux disease (GERD) and non-GERD esophagitis in children. Objective: The aim of our study was to study the spectrum of causes of esophagitis in cerebral palsy (CP) children with feeding difficulty. Methods: Children of CP with feeding difficulties in the age group of 1–18 years were included after written consent. Dysphagia in these children
was categorized according to the dysphagia disorder survey (DDS) score. Children who were unfit for endoscopy or having profound dysphagia were excluded from the study. UGI endoscopy and histopathological evaluation of esophagus was done in all the children. Results: Children of CP had a mean DDS score of 4.02±2.50. Endoscopic evidence of esophagitis was seen in 22 children (24.4%). Histological evidence was seen in 15 children; out of them, 11 had GERD-related esophagitis and 2 each had eosinophilic and fungal
esophagitis. The mean DDS score and weight significantly improved in children with GERD after they were given specific treatment. Conclusion: Esophagitis whether GERD or non-GERD is an important and treatable cause of dysphagia in children with CP. Effort should be made to recognize and treat these causes for effective nutritional rehabilitation of this subset of children.