Detection of Gastroesophageal Reflux in Children Using Combined Multichannel Intraluminal Impedance and pH Measurement: Data from the German Pediatric Impedance Group

Pilic, Denisa; Fröhlich, Thorsten; Nöh, F.; Pappas, Angeliki; Schmidt‐Choudhury, Anjona; Köhler, Henrik; Skopnik, H.; Wenzl, Tobias G.

doi:10.1016/j.jpeds.2010.09.033

Cited by 104 publications

(120 citation statements)

References 17 publications

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“…Baseline impedance has been shown to be more reduced in patients having esophagitis, as compared to patients experiencing non-erosive reflux disease. Additionally, proton pump inhibitor treatment outcomes have been shown to correlate with increased baseline impedance; however, this baseline impedance is also dependent on the patient's age, as well as the number of impedance events [16,17].…”

Section: Discussionmentioning

confidence: 99%

Evaluation of the Accuracy of Computer Automated Analysis of Esophageal 24- hour Impedance pH Studies

Sabouni¹,

Ghalayini²,

Bala³

et al. 2017

J Gastrointest Dig Syst

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Section: Discussionmentioning

confidence: 99%

Evaluation of the Accuracy of Computer Automated Analysis of Esophageal 24- hour Impedance pH Studies

Sabouni¹,

Ghalayini²,

Bala³

et al. 2017

J Gastrointest Dig Syst

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“…Esophageal pH-monitoring is one of the most convenient methods but it only recognizes acidic episodes of reflux 12,13,23,24 . A significant proportion of reflux episodes are known to be non-acidic, especially in infants [23][24][25][26][27] . As emphasized in the most recent guidelines, combined multiple intraluminal impedance and pH monitoring (MII-pH) is the most reliable method to evaluate GER 5,10 .…”

Section: Discussionmentioning

confidence: 99%

Detection of gastroesophageal reflux in children with cerebral palsy using combined multichannel intraluminal impedance-ph procedure

et al. 2016

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Gastroesophageal reflux (GER) is a very common condition in children with neurological impairment and this can influence nutritional and respiratory outcomes. The aim of this study was to investigate the presence of GER in children with cerebral palsy (CP) using multiple intraluminal impedance (MII)-pH monitoring. The use of combined MII-pH allows for the detection of both acid and non-acid reflux episodes. A total of 29 CP patients with symptoms suggesting GER, aged 2 to 10 years old, underwent 24-hour combined MII-pH monitoring. There were a total of 3899 reflux episodes, of which 29% were acid, 60% were weakly acid and 11% were alkaline. The number of non-acid reflux episodes was statistically significantly greater (p<0.01). These findings confirm that GER disease is seen frequently in children with cerebral palsy and most of the reflux episodes are not acidic. Non-acid reflux can also influence the morbidity in patients with cerebral palsy. It can be concluded that 70% of the reflux episodes would not have been recognized by pH measurement alone.

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“…In the recommendations of European Society for Pediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN) and North American Society for Pediatric Gastroenterology, Hepatology and Nutrition (NASPGHAN), pH-MII monitoring has been recognized as a superior diagnostic method than conventional pH monitoring and it is recommended to be used, instead of pH monitoring in children (1). Afterwards, several studies have shown that combined pH-MII monitoring is a more sensitive method for detecting RE than pH monitoring alone (5,14). It is now clear that a significant percentage of RE in infants and children is weakly acidic, and that weakly-acid reflux causes symptoms (5,14,15).…”

Section: Combined Ph-mii Monitoring: Advantages and Disadvantagesmentioning

confidence: 99%

“…Afterwards, several studies have shown that combined pH-MII monitoring is a more sensitive method for detecting RE than pH monitoring alone (5,14). It is now clear that a significant percentage of RE in infants and children is weakly acidic, and that weakly-acid reflux causes symptoms (5,14,15). Therefore, pH-MII monitoring is the most accurate diagnostic method for the detection and characterization of GER in children and infants.…”

Section: Combined Ph-mii Monitoring: Advantages and Disadvantagesmentioning

confidence: 99%

“…Extraesophageal (EE) symptoms are more common in infants and young children (1-5 years old) (4), whereas classical gastrointestinal (GI) symptoms are more often present in older children and adolescents (5). The most prevalent GER symptoms in infants are regurgitation with or without vomiting, and irritability, whereas in children and adolescents heartburn, epigastric pain and regurgitation (6).…”

Section: Introductionmentioning

confidence: 99%

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The significance of different methods for detection of gastroesophageal reflux in children

Ristic¹,

Kisić-Tepavčević²,

Milovanović³

2018

Medicinski podmladak

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Symptom-based diagnosis of gastroesophageal reflux disease (GERD) is not specific due to high prevalence of disorders that can mimic GERD. Conventional pH monitoring, combined pH-MII (multiple intraluminal impedance) monitoring and esophagogastroduodenoscopy are diagnostic methods most frequently used in children.Combined pH-MII monitoring is the most accurate diagnostic method for detecting GERD in children, which tends to become the gold standard. In infants and probably in children with extraesophageal symptoms, MII gives the greatest contribution to the validity of pH-MII monitoring. High prevalence of functional heartburn, in children older than 8 years, suggests the importance of pH-MII monitoring in this age group as well. The majority of studies showed age differences in the chemical composition of refluxate. Weakly acid reflux is more common in infants and is often associated with symptoms, whereas acid reflux is more common in older children and adolescent. Sensitivity of endoscopy is very low compared to pH-MII monitoring as a reference test. Although endoscopy is the method of choice for the confirmation of reflux esophagitis, pH-MII parameters are promising indicators of mucosal integrity, but further studies are needed.The major problem with pH-MII monitoring is a lack of normative data for children. Therefore, the standardization is mandatory. For the present pH-MII monitoring has limited impact on treatment due to the absence of effective therapy for weakly acid reflux, suggesting that further studies should be directed in this direction.

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Detection of Gastroesophageal Reflux in Children Using Combined Multichannel Intraluminal Impedance and pH Measurement: Data from the German Pediatric Impedance Group

Cited by 104 publications

References 17 publications

Evaluation of the Accuracy of Computer Automated Analysis of Esophageal 24- hour Impedance pH Studies

Evaluation of the Accuracy of Computer Automated Analysis of Esophageal 24- hour Impedance pH Studies

Detection of gastroesophageal reflux in children with cerebral palsy using combined multichannel intraluminal impedance-ph procedure

The significance of different methods for detection of gastroesophageal reflux in children

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