TY - JOUR
T1 - Addition of pH-Impedance Monitoring to Standard pH Monitoring Increases the Yield of Symptom Association Analysis in Infants and Children with Gastroesophageal Reflux
AU - Loots, Clara M.
AU - Benninga, Marc A.
AU - Davidson, Geoffrey P.
AU - Omari, Taher I.
PY - 2009
Y1 - 2009
N2 - Objective 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. Study design 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 1)H-only GER. Results 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. Conclusions 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. (J Pediatr 2009;154:248-52)
AB - Objective 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. Study design 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 1)H-only GER. Results 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. Conclusions 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. (J Pediatr 2009;154:248-52)
U2 - https://doi.org/10.1016/j.jpeds.2008.08.019
DO - https://doi.org/10.1016/j.jpeds.2008.08.019
M3 - Article
C2 - 18823910
SN - 0022-3476
VL - 154
SP - 248
EP - 252
JO - Journal of pediatrics
JF - Journal of pediatrics
IS - 2
ER -