title: Comparison of esophageal pH and multichannel intraluminal impedance testing in pediatric patients with suspected gastroesophageal reflux.
abstract: BACKGROUND
  Multichannel intraluminal impedance (MII) is a pH-independent method of assessing gastroesophageal reflux.
  
  
  OBJECTIVE
  To evaluate the diagnostic accuracy of MII-pH as compared with conventional pH monitoring in detecting reflux events (REs) and symptom association in different age groups.
  
  
  METHODS
  : A prospective direct comparison of 2 diagnostic techniques on 291 consecutive patients referred for suspected gastroesophageal reflux disease. Sensitivity and diagnostic accuracy of MII-pH versus pH monitoring and symptom association were measured.
  
  
  RESULTS
  MII-pH detected 13631 REs, 6260 (46%) of which were nonacid. The prevalence of weakly acid refluxes in the 24 hours and postprandial period as well as the proximal extension of refluxate were significantly greater in infants as compared with children (P < 0.001, P < 0.001, and P < 0.01, respectively). The diagnostic accuracy of combined MII-pH in revealing all RE and acid RE were significantly higher in infants as compared with children (92% vs 82%, P < 0.01 and 83% vs 76%, P < 0.04, respectively). The addition of MII to conventional pH monitoring significantly increases the diagnostic yield of symptom association analysis in revealing an association between atypical symptoms and refluxes irrespective of age, whereas in studying typical symptoms it was true only for infants.
  
  
  CONCLUSIONS
  Addition of MII to conventional pH monitoring significantly increases the diagnostic yield in detecting REs, prevalently in infants, and in revealing an association between refluxes and symptoms, prevalently respiratory ones and in infants group.
authors.affiliation: Department of Biomedicina dell'Età Evolutiva, University of Bari, Italy. rfrancavilla@libero.it
authors.forename: Ruggiero
authors.initials: R
authors.lastname: Francavilla
authors.forename: Anna Maria
authors.initials: AM
authors.lastname: Magistà
authors.forename: Nunzia
authors.initials: N
authors.lastname: Bucci
authors.forename: Antonietta
authors.initials: A
authors.lastname: Villirillo
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Boscarelli
authors.forename: Luigi
authors.initials: L
authors.lastname: Mappa
authors.forename: Gilda
authors.initials: G
authors.lastname: Leone
authors.forename: Stefania
authors.initials: S
authors.lastname: Fico
authors.forename: Stefania
authors.initials: S
authors.lastname: Castellaneta
authors.forename: Flavia
authors.initials: F
authors.lastname: Indrio
authors.forename: Elena
authors.initials: E
authors.lastname: Lionetti
authors.forename: Fulvio
authors.initials: F
authors.lastname: Moramarco
authors.forename: Luciano
authors.initials: L
authors.lastname: Cavallo
mesh_terms: D000293:Adolescent; D000367:Age Factors; D002648:Child; D002675:Child, Preschool; D017097:Electric Impedance; D050782:Esophageal pH Monitoring; D004947:Esophagus / Q000503:physiopathology*; D005260:Female; D005744:Gastric Acid; D005764:Gastroesophageal Reflux / Q000175:diagnosis* / Q000503:physiopathology; D006801:Humans; D006863:Hydrogen-Ion Concentration; D007223:Infant; D008297:Male; D015995:Prevalence; D011446:Prospective Studies; D015203:Reproducibility of Results