{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,15]],"date-time":"2026-06-15T08:58:32Z","timestamp":1781513912947,"version":"3.54.1"},"reference-count":24,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,6,15]],"date-time":"2026-06-15T00:00:00Z","timestamp":1781481600000},"content-version":"vor","delay-in-days":165,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatrics International"],"published-print":{"date-parts":[[2026,1]]},"abstract":"ABSTRACT<\/jats:title>\n \n Background<\/jats:title>\n Duodenogastric reflux (DGR), the backward flow of duodenal contents into the stomach, is often overlooked in children. This study aimed to evaluate the endoscopic and histopathological changes in the esophagus associated with DGR in children.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n This retrospective study included 537 children aged 0\u201318\u2009years who underwent esophagogastroduodenoscopy (EGD). DGR was defined by the presence of bile in the stomach upon initial endoscope entry together with concurrent endoscopic or histopathological evidence of gastritis. Conditions that could potentially confound the findings were excluded using defined exclusion criteria. Endoscopic and histopathological findings of the esophagus, stomach, and duodenum were evaluated for each patient.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n DGR was detected in 22% of the patients. Endoscopic findings such as esophageal hyperemia, erosion, and ulceration were significantly more frequent in the DGR group (\n p<\/jats:italic>\n \u2009<\u20090.001). Histopathologically, the frequency and severity of esophagitis were also higher in patients with DGR (\n p<\/jats:italic>\n \u2009=\u20090.002 and\n p<\/jats:italic>\n \u2009=\u20090.019, respectively). DGR was independently associated with higher odds of both endoscopic (Odds ratio (OR): 2.18,\n p<\/jats:italic>\n \u2009=\u20090.004) and histopathological esophagitis (OR: 1.80,\n p<\/jats:italic>\n \u2009=\u20090.008). Endoscopic signs of gastric mucosal injury, including erythema, friability, edema, and ulcers, were more common in the DGR group (\n p<\/jats:italic>\n \u2009<\u20090.001); however, these findings were interpreted descriptively because gastritis was part of the DGR definition, and no significant difference was observed in gastric histopathology.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n In pediatric patients, DGR is associated with significant esophageal mucosal injury at both endoscopic and histopathological levels. These findings indicate an increased risk of esophagitis in children with DGR and support the clinical value of esophageal biopsy during pediatric EGD.<\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/ped.70449","type":"journal-article","created":{"date-parts":[[2026,6,15]],"date-time":"2026-06-15T08:46:24Z","timestamp":1781513184000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Endoscopic and Histological Features of Esophagitis in Children With Duodenogastric Reflux"],"prefix":"10.1111","volume":"68","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1885-6611","authenticated-orcid":false,"given":"Sel\u00e7uk","family":"Teke","sequence":"first","affiliation":[{"name":"Department of Pediatrics; Pediatric Gastroenterology, Hepatology and Nutrition, Gulhane Training and Research Hospital Health Science University Ankara Turkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3689-6852","authenticated-orcid":false,"given":"Yasin Maruf","family":"Ergen","sequence":"additional","affiliation":[{"name":"Department of Pediatrics; Pediatric Gastroenterology, Hepatology and Nutrition, Gulhane Training and Research Hospital Health Science University Ankara Turkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3165-3234","authenticated-orcid":false,"given":"Edibe Gozde","family":"Basaran","sequence":"additional","affiliation":[{"name":"Department of Pediatrics; Pediatric Gastroenterology, Hepatology and Nutrition, Gulhane Training and Research Hospital Health Science University Ankara Turkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0364-0401","authenticated-orcid":false,"given":"Tugce","family":"Oznacar","sequence":"additional","affiliation":[{"name":"Department of Biostatistics Ankara Medipol University Ankara Turkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8665-5611","authenticated-orcid":false,"given":"Necati","family":"Balamtekin","sequence":"additional","affiliation":[{"name":"Department of Pediatrics; Pediatric Gastroenterology, Hepatology and Nutrition, Gulhane Training and Research Hospital Health Science University Ankara Turkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,6,15]]},"reference":[{"issue":"6","key":"e_1_2_10_2_1","doi-asserted-by":"crossref","first-page":"822","DOI":"10.1016\/j.soard.2019.03.034","article-title":"Duodenogastric Biliary Reflux Assessed by Scintigraphic Scan in Patients With Reflux Symptoms After Sleeve Gastrectomy: Preliminary Results","volume":"15","author":"Braghetto I.","year":"2019","journal-title":"Surgery for Obesity and Related Diseases"},{"issue":"4","key":"e_1_2_10_3_1","first-page":"411","article-title":"Duodenogastric Reflux in Health and Disease: Insights From a Computational Fluid Dynamics Model of the Stomach","volume":"328","author":"Kuhar S.","year":"2025","journal-title":"American Journal of Physiology: Gastrointestinal and Liver Physiology"},{"issue":"2","key":"e_1_2_10_4_1","doi-asserted-by":"crossref","first-page":"10","DOI":"10.1111\/j.1365-2036.2006.03040.x","article-title":"Review Article: The Role of Bile and Pepsin in the Pathophysiology and Treatment of Gastro\u2010Oesophageal Reflux Disease","volume":"24","author":"Tack J.","year":"2006","journal-title":"Alimentary Pharmacology & Therapeutics"},{"key":"e_1_2_10_5_1","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1155\/2022\/2642551","article-title":"Bile Reflux Gastritis: Insights Into Pathogenesis, Relevant Factors, Carcinomatous Risk, Diagnosis, and Management","volume":"2022","author":"Shi X.","year":"2022","journal-title":"Gastroenterology Research and Practice"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.isci.2024.109118"},{"issue":"2","key":"e_1_2_10_7_1","first-page":"266","article-title":"Bile in the Esophagus: A Factor in the Pathogenesis of Reflux Esophagitis in Children","volume":"36","author":"Orel R.","year":"2003","journal-title":"Journal of Pediatric Gastroenterology and Nutrition"},{"key":"e_1_2_10_8_1","doi-asserted-by":"crossref","DOI":"10.1016\/j.jep.2024.119037","article-title":"Sesquiterpene\u2010Enriched Extract of Chinese Agarwood (\n Aquilaria sinensis\n ) Alleviates Bile Reflux Gastritis Through Suppression of Gastric Mucosal Cell Apoptosis via the Wnt\/\u03b2\u2010Catenin Signaling Pathway","volume":"338","author":"Ma J.","year":"2025","journal-title":"Journal of Ethnopharmacology"},{"issue":"6","key":"e_1_2_10_9_1","doi-asserted-by":"crossref","DOI":"10.1172\/jci.insight.168112","article-title":"Prebiotic Proanthocyanidins Inhibit Bile Reflux\u2010Induced Esophageal Adenocarcinoma Through Reshaping the Gut Microbiome and Esophageal Metabolome","volume":"9","author":"Weh K. M.","year":"2024","journal-title":"JCI Insight"},{"issue":"3","key":"e_1_2_10_10_1","doi-asserted-by":"crossref","first-page":"276","DOI":"10.1159\/000517263","article-title":"The Relationship Between Primary Duodenogastric Reflux and \n Helicobacter pylori\n Gastritis in Children","volume":"40","author":"Arslan M.","year":"2022","journal-title":"Digestive Diseases"},{"issue":"1","key":"e_1_2_10_11_1","doi-asserted-by":"crossref","first-page":"122","DOI":"10.24953\/turkjped.2020.2839","article-title":"Does Bile Reflux Reduce \n Helicobacter pylori\n Gastritis?","volume":"64","author":"Ta\u015fc\u0131 E. K.","year":"2022","journal-title":"Turkish Journal of Pediatrics"},{"issue":"12","key":"e_1_2_10_12_1","doi-asserted-by":"crossref","DOI":"10.3390\/medicina55120775","article-title":"The Effect of Primary Duodenogastric Bile Reflux on the Presence and Density of Helicobacter Pylori and on Gastritis in Childhood","volume":"55","author":"Agin M.","year":"2019","journal-title":"Medicina"},{"issue":"6","key":"e_1_2_10_13_1","doi-asserted-by":"crossref","first-page":"343","DOI":"10.1007\/s00431-025-06163-z","article-title":"Histopathological Differences in Pediatric Duodenogastric Reflux: A Comparative Study","volume":"184","author":"T\u00fcrker S. 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