Comparison of esophageal pH and multichannel intraluminal impedance testing in pediatric patients with suspected gastroesophageal reflux.
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.
Francavilla
Ruggiero
R
Department of Biomedicina dell'Età Evolutiva, University of Bari, Italy. rfrancavilla@libero.it
Magistà
Anna Maria
AM
Bucci
Nunzia
N
Villirillo
Antonietta
A
Boscarelli
Giuseppe
G
Mappa
Luigi
L
Leone
Gilda
G
Fico
Stefania
S
Castellaneta
Stefania
S
Indrio
Flavia
F
Lionetti
Elena
E
Moramarco
Fulvio
F
Cavallo
Luciano
L
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