The Correlation between Endoscopic Reflux Esophagitis and Combined Multichannel Intraluminal Impedance-pH Monitoring in Children

Liu, Yuwen; Wu, Jia‐Feng; Chen, Huey‐Ling; Hsu, Hong–Yuan; Hsu, Wei‐Chung; Tseng, Ping‐Huei; Wang, Hsiu-Po; Ni, Yen‐Hsuan

doi:10.1016/j.pedneo.2015.09.008

Cited by 15 publications

(19 citation statements)

References 22 publications

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“…The six impedance segments defined the six zones along the esophagus, Z1 to Z6, which were centered at 17, 15, 9, 7, 5, and 3 cm above the lower esophagus sphincter, respectively, with Z1 being most proximal to the upper incisor. The three pH electrodes were located in the stomach, 5 cm above the lower esophageal sphincter and 21 cm above the lower esophageal sphincter . All of the segments and electrodes were assumed to locate in the esophagus.…”

Section: Methodsmentioning

confidence: 99%

Double‐blind, placebo‐controlled study with alginate suspension for laryngopharyngeal reflux disease

Tseng

et al. 2018

The Laryngoscope

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Section: Methodsmentioning

confidence: 99%

Double‐blind, placebo‐controlled study with alginate suspension for laryngopharyngeal reflux disease

Tseng

et al. 2018

The Laryngoscope

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“…Thus, the mean number of weakly acidic reflux episodes were determined at double the rate of the mean number of acidic reflux episodes, which was statistically significant (p<0.01). In a recent study, Liu et al 26 showed that MII-pH monitoring detected a 3-fold increase in nonacid reflux episodes in comparison with acid reflux episodes. The impact of non-acid reflux is very important in a study population such as the one in the current study.…”

Section: Discussionmentioning

confidence: 99%

“…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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“…These results suggest that weakly acidic reflux may play a role in the pathogenesis of reflux esophagitis (14). Study by Liu et al found that the best predictors of reflux esophagitis are DeMeester score ≥ 21 and the duration of the longest acid reflux ≥ 17 minutes, as well as the occurrence of acid reflux over 5 minutes (36). These results indicate that macroscopic changes of esophageal mucosa are more common in patients with increased exposure to acid, as previously reported in adult studies (52).…”

Section: The Role Of Ph-mii Parameters In Prediction Of Reflux Esophamentioning

confidence: 93%

“…Endoscopy is a highly specific (90-95%) method for diagnosing of GERB (14,36,37). The sensitivity of endoscopy is low and does not exceed 50% in different studies (referent test pH-MII monitoring) (14,25,38).…”

Section: Combined Ph-mii Monitoring: Advantages and Disadvantagesmentioning

confidence: 99%

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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The Correlation between Endoscopic Reflux Esophagitis and Combined Multichannel Intraluminal Impedance-pH Monitoring in Children

Abstract: MII-pH monitoring not only raised the diagnostic yield in identifying GER, but it also showed significant correlation with the presence of endoscopically proven reflux esophagitis in children.

Cited by 15 publications

References 22 publications

Double‐blind, placebo‐controlled study with alginate suspension for laryngopharyngeal reflux disease

Double‐blind, placebo‐controlled study with alginate suspension for laryngopharyngeal reflux disease

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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