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https://hdl.handle.net/2440/52413
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Type: | Journal article |
Title: | Addition of pH-impedance monitoring to standard pH monitoring increases the yield of symptom association analysis in infants and children with gastroesophageal reflux |
Author: | Loots, C. Benninga, M. Davidson, G. Omari, T. |
Citation: | Journal of Pediatrics, 2009; 154(2):248-252 |
Publisher: | Mosby Inc |
Issue Date: | 2009 |
ISSN: | 0022-3476 1097-6833 |
Statement of Responsibility: | Clara M. Loots, Marc A. Benninga, Geoffrey P. Davidson and Taher I. Omari |
Abstract: | <h4>Objective</h4>To assess the additional yield of combined multichannel intraluminal pH-impedance (pH-MII) monitoring compared with standard pH monitoring on gastroesophageal reflux (GER) symptom associations in infants and children.<h4>Study design</h4>In 80 patients, 24-hour ambulatory pH-MII monitoring was performed. Tracings were analyzed with established pH-MII criteria. Symptoms of regurgitation and belching were excluded from analysis, because these were considered to be a direct consequence of GER. Standard GER-symptom correlation indices were calculated with: 1) standard pH monitoring; 2) MII detection of liquid and mixed bolus GER; 3) MII detection of all bolus GER (liquid, mixed, and gas); 4) pH-MII detection of all GER, including pH-only GER.<h4>Results</h4>Fifty patients (21 children) were included. MII detection of all bolus GER yielded a significantly greater number of patients who were symptom-positive, 36 (72%) compared with 25 (50%) with standard pH-monitoring (P = .04). A positive symptom association was observed in 8 of 10 (80%) patients with pathological esophageal acid exposure and 28 of 40 (70%) patients with negative pH-findings.<h4>Conclusions</h4>A high proportion of patients with normal esophageal acid exposure had a positive symptom association on pH-MII monitoring. Including all MII-detected bolus GER and excluding pH-only GER for analysis optimizes the yield of GER-symptom associations in infants and children. |
Keywords: | Esophagus Humans Gastroesophageal Reflux Gastric Acidity Determination Electric Impedance Child, Preschool Infant Esophageal pH Monitoring |
DOI: | 10.1016/j.jpeds.2008.08.019 |
Published version: | http://dx.doi.org/10.1016/j.jpeds.2008.08.019 |
Appears in Collections: | Aurora harvest 5 Paediatrics publications |
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