Background and aims The study compares the 24 h esophageal pH-metry, used to be considered the “gold diagnosis” for the gastroesophageal reflux, with the esophagitis degree observed at the upper digestive endoscopy.

Material 72 children were included, aged over 4 years old, admitted in a paediatric gastroenterology regional centre in northeast Romania, diagnosed with gastroesophageal reflux disease (GERD) by 24 hours pH-metry (with a positive Boix Ochoa score), which also underwent the upper digestive endoscopy.

Results Out of the 72 children diagnosed with GERD, 47 (65.28%) had first degree esophagitis and 25 (34.72%) second degree esophagitis. In GERD associated with second degree esophagitis the Boix Ochoa score is statistically significant higher compared with the GERD associated with first degree esophagitis (F = 9.76, p = 0.0036, 95% CI).

Conclusions Upper digestive endoscopy performed in patients with gastroesophageal reflux disease shows the constant presence of esophagitis at all patients. There were only first and second degree esophagitis due to the fact that they are young patients with a relative short history of the disease. The correlation tests show a perfect parallel between the pH-metry scores and the endoscopic lesion. The correlation is so accurate that the pH-metry scores can be sufficient to prove the disease and the esophagitis degree, the upper digestive endoscopy being reserved only for the cases that does not respond to the medical treatment or have other complications.