Objectives To determine the clinico-epidemiological characteristics of pediatric esophagitis in southern Iran.

Methods A cross-sectional study was conducted during a 4-year period from 2005 to 2009 in Nemazee hospital, a tertiary healthcare center in Shiraz, southern Iran. We consecutively included all the pediatric patients (< 18 years) who underwent endoscopy in our center and had pathology-confirmed diagnosis of esophagitis. Data regarding the patients’ demographic characteristics, comorbidities, and clinical findings were recorded using a questionnaire. All the patients underwent upper GI endoscopy and biopsy of the esophagus and the findings were recorded in the questionnaire.

Results We studied 125 children among whom there were 61 (48.8%) girls and 64 (51.2%) boys with mean age of 6.6±5.5 years. Intractable vomiting was the prominent symptom in our series being reported by 75 (60%) patients followed by fever in 35 (28%). Erythema (33.6%), esophageal ulcer (11.2%), and whitish patch (8.0%) were the most common endoscopic findings while reflux esophagitis (32.8%), chronic (6.4%) and acute esophagitis (5.6%), and candida esophagitis (5.6%) were the most common histological diagnoses. Just 1 (0.8%) patient was diagnosed as having eosinophilic esophagitis, aspergillosis, and graft versus host disease.

Conclusion Reflux is the most common cause of esophagitis in the pediatric population of southern Iran. Despite previous reports the prevalence of eosinophilic esophagitis is far less than estimated while the prevalence of opportunistic infections is higher secondary to post liver transplantation immunosuppression.