Esophageal Impedance/pH Monitoring in Pediatric Patients: Preliminary Experience with 50 Cases

Abstract

This paper describes multiple intraluminal impedance (MII) in 50 children with typical and atypical gastroesophageal reflux (GER) symptoms and discusses the possible clinical significance of objective numeric data provided by MII computed analysis. Patients underwent 24-hr pH/MII monitoring. Reflux parameters were analyzed with relation to age and reported symptoms. Nonacidic MII events occurred as frequently as acidic ones. A Pathologic Bolus Exposure Index associated with a normal pH Reflux Index was detected in 26% of our series. Significant correlations were found regarding acid and bolus clearing times and their ratio. We conclude that the low rate of symptom occurrence in the pediatric population represents a limit on MII evaluation. Our study confirmed that nonacid GER is at least as frequent as acid GER. As MII provides interesting objective data that could be used in clinical practice, we suggest further research to define normal ranges in the pediatric population.

Evaluation of esophageal motility and reflux in children treated for esophageal atresia with the use of combined multichannel intraluminal impedance and pH monitoring

“…Multichannel intraluminal impedance (MII) has recently been added to the repertoire of tests available to study esophageal (patho)physiology in children [1][2][3][4][5][6]. Thus far, MII has been used in 2 major areas: diagnosis of gastroesophageal reflux disease (GERD) and esophageal function testing [7][8].…”

Combined 24-Hours Esophageal Ph Monitoring and Multichannel Intraluminal Impedance for Comparison of Gastroesophageal Reflux in Children With Typical Versus Atypical Symptoms of Gastroesophageal Reflux Disease

“…Mattioli and colleagues' were tested pH monitoring and MII methods on 50 children with GERD (9) . According to their findings, acid and non-acid reflux had the same incidence and low rate of clinical symptoms in pediatric group is considered as a limitation of the MII.…”

“…According to their findings, acid and non-acid reflux had the same incidence and low rate of clinical symptoms in pediatric group is considered as a limitation of the MII. They suggested further studies on accuracy and precision of MII (9) . According to our findings, there were no statistically different in terms of demographic characteristics of patients in the two typical and atypical groups.…”

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

“…Studies have shown that feeding difficulties, chronic pulmonary aspiration, constipation, malnutrition and GER are the major problems in children with CP There are advantages and disadvantages of each method, and the facilities and experience of the center are also important when selecting the test to be used. 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] .…”

“…The intraluminal catheter also has a pH sensor. Thus, a combined esophageal multichannel intraluminal impedance-pH (MIIpH) technique may detect all GER episodes and classify GER episodes according to their pH value and proximal extension [9][10][11][12][13][14] .…”