Prolonged pH monitoring is of limited usefulness for gastroesophageal reflux.
OBJECTIVE
To assess the diagnostic value of pH monitoring.


METHODS
A prospective study.


METHODS
Pediatric university hospital serving as a secondary and tertiary referral center.


METHODS
Thirty-eight infants, aged 1 to 12 months, and 26 children, aged 13 months to 18 years, admitted during a 2-year period because of clinically significant gastroesophageal reflux (GER).


METHODS
Prolonged (20-hour) pH monitoring as well as endoscopy and biopsy of the esophagus were carried out in all patients who, on the basis of clinical data, were classified as having mild, moderate, or severe GER disease.


RESULTS
In the infant group, results of prolonged pH monitoring were abnormal in 34 (89.5%). In the older group, results were abnormal in less than half (11 [42.3%]) of the cases. In both groups, pH monitoring data did not correlate with the severity of GER disease or of esophagitis. Severity of GER disease was not predictive of esophagitis.


CONCLUSIONS
(1) Endoscopy and biopsy of the esophagus should be the first procedures whenever there are clinical findings of moderate to severe GER disease. (2) Monitoring of pH should be restricted to those patients without a clear-cut history of GER disease.
Department of Pediatrics, Hôpital Sainte-Justine, Montreal, Quebec, Canada.
C
C
Ferreira
M J
MJ
Lohouès
A
A
Bensoussan
S
S
Yazbeck
P
P
Brochu
C C
CC
Roy
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D005764:Gastroesophageal Reflux / Q000175:diagnosis* / Q000378:metabolism; D006801:Humans; D006863:Hydrogen-Ion Concentration; D007223:Infant; D008297:Male; D008991:Monitoring, Physiologic; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012720:Severity of Illness Index; D013997:Time Factors