Evaluation of gastroesophageal reflux in pediatric patients with asthma using impedance–pH monitoring

Condino, Adria A.; Sondheimer, Judith M.; Pan, Zhaoxing; Gralla, Jane; Perry, Darryl; OʼConnor, Judith

doi:10.1016/j.jpeds.2006.03.022

Cited by 71 publications

(63 citation statements)

References 14 publications

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“…This limitation is particularly important in the postprandial period and in infants, in whom this technique is blind for half the recording time (2,20) . Multichannel intraluminal impedance monitoring has recently been described as the only method offering high sensitivity for the detection of all types of reflux events (17) .…”

Section: Discussionmentioning

confidence: 99%

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

Dehghani

Taghavi

Javaherizadeh

et al. 2016

Arq. Gastroenterol.

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-Background -Gastroesophageal reflux disease is the most common esophageal disorder in pediatrics.Objective -The aim of this study was to compare reflux parameters of typical and atypical symptoms of gastroesophageal reflux disease using 24-hour esophageal pH monitoring and multichannel intraluminal impedance in pediatric population. Methods -In this prospective study, 43 patients aged less than 18 year with suspected gastroesophageal reflux disease were enrolled. The patients were divided into two groups based on the main presenting symptoms (typical versus atypical). Twenty four-hour pH monitoring and multichannel intraluminal impedance were performed in all the patients for comparing these two group regarding association of symptoms and reflux. Number of refluxes, pH related reflux, total reflux time, reflux more than 5 minutes, longest time of the reflux, lowest pH at reflux, reflux index were recorded and compared. Data comparison was done using SPSS.Results -The mean age of the patients was 5.7±3.4 years and 65.1% were male. Out of 43 patients 24 cases had typical symptoms and 19 had atypical symptoms. The mean reflux events detected by multichannel intraluminal impedance was more than mean reflux events detected by pH monitoring (308.4±115.8 vs 69.7±66.6) with P value of 0.037, which is statistically significant. The mean symptom index and symptom association probability were 35.01% ± 20.78% and 86.42% ± 25.79%, respectively in multichannel intraluminal impedance versus 12.73% ± 12.48% and 45.16% ± 42.29% in pH monitoring (P value <0.001). Number of acid reflux was 46.26±47.16 and 30.9±22.09 for atypical and typical symptoms respectively. The mean symptom index was 18.12% ± 13.101% and 8.30% ± 10.301% in atypical and typical symptoms respectively (P=0.034). Bolus clearance was longer in atypical symptoms compared typical symptoms(P<0.05). Conclusion -Symptom index was significantly higher in atypical symptoms compared to typical symptoms. Higher number of acid reflux was found in children with atypical symptoms of reflux. Longer duration of bolus clearance was found in group with atypical symptoms of reflux.

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Section: Discussionmentioning

confidence: 99%

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

Dehghani

Taghavi

Javaherizadeh

et al. 2016

Arq. Gastroenterol.

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“…Nevertheless, a study of 25 children with chronic respiratory symptoms showed high frequency of acidic REs and a very small number of weakly acidic REs (ratio 19:1), with a negative SI for all types of reflux and a positive SSI for acidic and weakly acidic reflux (31). Another study of 24 children with asthma showed the same frequency of acidic and weakly acidic reflux, without clear temporal association for most of the symptoms (32). Study of children with respiratory symptoms on PPIs revealed the correlation between symptoms and weakly acidic reflux, that was stronger in younger children (33).…”

Section: Combined Ph-mii Monitoring: Advantages and Disadvantagesmentioning

confidence: 96%

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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“…Wykorzystanie pH-impedancji w diagnostyce GER pozwala na rejestrację nie tylko incydentów zarzucania treści kwaśnej, ale również monitorowanie epizodów niekwaśnych, a także ocenę wysokości, na jaką cofa się refluksat. Publikacje dotyczące wykorzystania pH-impedancji w diagnostyce GER u osób z AO są nieliczne i w większości dotyczą pacjentów dorosłych [19][20][21][22][23].…”

Section: Wstępunclassified

Influence of gastroesophageal reflux measured by pH-impedance on asthma control degree in children and youth

Szaflarska-Popławska¹,

Popławski²

2011

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Evaluation of gastroesophageal reflux in pediatric patients with asthma using impedance–pH monitoring

Cited by 71 publications

References 14 publications

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

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

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

Influence of gastroesophageal reflux measured by pH-impedance on asthma control degree in children and youth

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