Gastro-oesophageal reflux in children: comparison of different durations, positions and sleep-awake periods of pH monitoring in the same patient.
A group of 72 children (mean age: 21.7 months, range: 14 days-19 years) with symptoms of gastro-oesophageal reflux were investigated by 22 h pH monitoring. Using a Proxeda software, we compared, in the same patient, the specificity and sensitivity of pH monitoring during 3 h, 6 h, 12 h, 12 nocturnal hours and 3 postprandial hours, as well as the influence of position and the sleep and alert periods. Results showed that all the short pH monitorings were statistically less sensitive than 22 h pH monitoring (P < 0.025). As regards specificity, only the 12 nocturnal hours pH monitoring was not statistically different from the 22 h pH monitoring. Gastro-oesophageal reflux was more frequent when the patient was awake than during sleep. pH monitoring seemed more reliable in the recumbent than in the upright position. We conclude that long-term pH monitoring (22 h) is the test of choice to diagnose gastro-oesophageal reflux because it included sleep and alert periods as well as different positions.
Schilter
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Le Coultre
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Belli
D C
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D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D005764:Gastroesophageal Reflux / Q000378:metabolism* / Q000503:physiopathology; D006801:Humans; D006863:Hydrogen-Ion Concentration; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008991:Monitoring, Physiologic / Q000379:methods; D011187:Posture / Q000502:physiology*; D012680:Sensitivity and Specificity; D012890:Sleep / Q000502:physiology*; D013997:Time Factors; D014851:Wakefulness / Q000502:physiology