BSPGHAN Motility Working Group position statement: paediatric multichannel intraluminal pH impedance monitoring—indications, methods and interpretation

Mutalib, Mohamed; Rawat, David; Lindley, Keith; Borrelli, Osvaldo; Perring, S.; Auth, Marcus K.H.; Thapar, Nikhil

doi:10.1136/flgastro-2016-100796

Cited by 26 publications

(26 citation statements)

References 31 publications

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“…The age appropriate catheter (Pediatric ZandorpH catheter with 1 Antimony and 6 impedance rings with 2 cm interval, Laborie, The Netherlands) was inserted after EGD and under general anesthesia. When the patient woke up, the catheter position was adjusted to place pH sensor at 2 vertebraes above the diaphragm from a plain chest x-ray in upright and full inspired position, followed the statement from British Society of Paediatric Gastroenterology, Hepatology and Nutrition (BSPGHAN) motility working group[ 10 ]. All chest X-ray was reviewed by a pediatric gastroenterologist (Sintusek P) to confirm the proper position.…”

Section: Methodsmentioning

confidence: 99%

Detection of reflux-symptom association in children with esophageal atresia by video-pH-impedance study

Maholarnkij

Sanpavat

Decharun

et al. 2020

WJG

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BACKGROUND Children with esophageal atresia (EA) have risk of gastroesophageal reflux disease (GERD), suggesting reflux monitoring for prompt management. AIM To evaluate GERD in children with EA and specific symptom association from combined Video with Multichannel Intraluminal Impedance and pH (MII-pH) study. METHODS Children diagnosed with EA with suspected GERD and followed up at King Chulalongkorn Memorial Hospital between January 2000 and December 2018 were prospectively studied. All underwent esophagogastroduodenoscopy with esophageal biopsy and Video MII-pH study on the same day. Symptoms of GERD which included both esophageal and extra-esophageal symptom were recorded from video monitoring and abnormal reflux from MII-pH study based on the statement from the European Paediatric Impedance Group. Prevalence of GERD was also reported by using histopathology as a gold standard. Endoscopic appearance was recorded using Los Angeles Classification and esophagitis severity was graded using Esohisto criteria. RESULTS Fifteen children were recruited with age of 3.1 (2.2, 9.8) years (40%, male) and the common type was C (93.3%). The symptoms recorded were cough (75.2%), vomiting (15.2%), irritability or unexplained crying (7.6%) and dysphagia (1.9%) with the symptom-reflux association of 45.7%, 89%, 71% and 0%, respectively. There were abnormal endoscopic appearance in 52.9%, esophagitis in 64.7% and high reflux score in 47.1%. Video MII-pH study has high diagnostic value with the sensitivity, specificity and accuracy of 72.7%, 100% and 82.4%, respectively. CONCLUSION Prevalence of GERD in children with EA was high. Video MII-pH study to detect GERD in children with EA had high diagnostic value with the trend of specific symptom association.

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Section: Methodsmentioning

confidence: 99%

Detection of reflux-symptom association in children with esophageal atresia by video-pH-impedance study

Maholarnkij

Sanpavat

Decharun

et al. 2020

WJG

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“…Multichannel intraluminal impedance combined with pH (MII‐pH) detects acid, weak acid and non-acid reflux episodes and is superior to pH metry 38. MII-pH monitoring is now becoming the investigation of choice for diagnosing GOR 39…”

Section: Discussionmentioning

confidence: 99%

Paroxysmal head drops with ataxia-like symptoms presenting as Sandifer syndrome in a 3-year old girl

et al. 2020

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We present a case of Sandifer syndrome in a 3-year-old girl who initially presented with a history of recurrent paroxysmal head drops associated with ataxia-like symptoms and recurrent falls sustaining a clavicular fracture on one occasion. She was referred to and seen by the paediatric neurologist. Physical examination, electroencephalogram, MRI brain, electromyograph single fibre study and blood tests were all normal. With the history of hiccups and choking-like episodes she was referred to the speech and language therapist (SALT). SALT assessment did not reveal indications of swallowing impairment or possible aspiration. A barium swallow later showed small amount of reflux into the distal oesophagus. This prompted a trial of lansoprazole and she was referral to the gastroenterologists. Endoscopy and oesophageal manometry were essentially normal. However, the pH impedance study revealed severe gastro-oesophageal reflux disease. She continued with lansoprazole and dairy-free diet and her symptoms resolved.

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“…Die Impedanzmessung (sogenannte "multichannel intraluminal impedance") ist der pH-Metrie zwar überlegen, sie ist jedoch nicht standardisiert. Weiterhin existieren keine Normalwerte für diese aufwendige Methode [62]. Die Röntgenuntersuchung mit Refluxtestung (sogenannter "Breischluck") erlaubt den Ausschluss anatomischer Pathologien wie einer Hiatushernie oder Malrotation (4 % der Fälle).…”

Section: Gastroösophageale Refluxkrankheit (Görk)unclassified

Behandlung der Ösophagusatresie mit unterer tracheoösophagealer Fistel – Zusammenfassung der aktuellen S2K-Leitlinie der DGKCH

Mayer

Gitter

Göbel³

et al. 2020

Klin Padiatr

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ZusammenfassungDie Ösophagusatresie (ÖA) ist eine angeborene Kontinuitätsunterbrechung der Speiseröhre mit oder ohne Fistel zur Trachea (Tracheoösophageale Fistel, TÖF). Je nach Abstand zwischen den beiden Ösophagusenden unterscheidet man eine „kurzstreckige“ von einer „langstreckigen“ Form. Bis zu 50% der Neugeborenen weisen weitere Anomalien auf. Eine pränatale Diagnose der ÖA gelingt in 32–63% der Fälle. Die interdisziplinäre Betreuung dieser Kinder hat sich in den letzten Jahren gewandelt. In der folgenden Arbeit wird die aktuelle S2K-Leitlinie der Deutschen Gesellschaft für Kinderchirurgie zur Behandlung der ÖA mit unterer TÖF, die etwa 90% aller Fälle ausmacht, zusammengefasst. Hierzu gehören das präoperative Management sowie operative und anästhesiologische Aspekte (u. a. Thorakoskopie vs. Thorakotomie, präoperative Tracheobronchoskopie, intraoperative Hyperkapnie und Azidose). Ferner wird das postoperative Management insbesondere von relevanten Komplikationen wie der Anastomosenstenose beschrieben. Trotz Fortschritten in der Behandlung der ÖA ist die Langzeitmorbidität mit Motilitätsstörungen des Ösophagus, gastroösophagealer Refluxkrankheit, rezidivierenden Infektionen der oberen und unteren Atemwege, Tracheomalazie, mangelhaftem Gedeihen sowie orthopädischen Problemen nach Thorakotomie weiterhin hoch. Zum Erreichen einer guten Lebensqualität ist daher eine gute interdisziplinäre Nachsorge wichtig.

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BSPGHAN Motility Working Group position statement: paediatric multichannel intraluminal pH impedance monitoring—indications, methods and interpretation

Abstract: MII-pH is increasingly used by paediatricians as the diagnostic tool for assessing gastro-oesophageal reflux disease and symptom association. There is wide variation in paediatric practice and a need for standardised practice.

Cited by 26 publications

References 31 publications

Detection of reflux-symptom association in children with esophageal atresia by video-pH-impedance study

Detection of reflux-symptom association in children with esophageal atresia by video-pH-impedance study

Paroxysmal head drops with ataxia-like symptoms presenting as Sandifer syndrome in a 3-year old girl

Behandlung der Ösophagusatresie mit unterer tracheoösophagealer Fistel – Zusammenfassung der aktuellen S2K-Leitlinie der DGKCH

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