Esophageal impedance and esophagitis in children: any correlation?
OBJECTIVE
: The aim of this study was to correlate the data obtained with multiple intraluminal esophageal impedance and pH (MII-pH) recordings in infants and children referred for suspected gastroesophageal reflux disease with esophageal histology.


METHODS
: In a prospective study, results of esophageal biopsies and MII-pH recording obtained in 45 children (mean age +/- SD: 69 +/- 55 months) were analyzed. Regarding the MII-pH data, an automatic (Autoscan Bioview Analysis Software, version 5.3.4, Sandhill Scientific Inc, Highlands Ranch, CO) and a manual reading were performed; an automatic pH analysis (meal included) was also performed.


RESULTS
: Acidic, weakly acidic, and alkaline reflux episodes accounted, respectively, for 48.7%, 49.5%, and 1.8% of the total number of reflux episodes detected by MII-pH. Esophagitis was present in 25 (56%) children. Concordance between classic pH-study analysis (alone) and esophageal histology was found in 19 of 45 (42%) children. According to the MII-pH analysis, the mean and median value of the pH were significantly higher in the group with esophagitis than in the group with normal esophageal histology. A longer clearance time was found in the group with esophagitis than in subjects with normal histology. Gas reflux episodes represented 21% of the total reflux episodes and were comparable in both groups.


CONCLUSIONS
: Multiple intraluminal esophageal impedance and pH analysis does not provide a distinct parameter to predict esophageal mucosal injury in children. In our population, MII-pH shows comparable acidic, weakly acidic, alkaline, and gas reflux in children with and without esophagitis. Further research is needed to analyze clearance parameters.
Salvatore
S
S
Clinica Pediatrica, Università dell'Insubria, Varese, Italy.
Hauser
B
B
Devreker
T
T
Arrigo
S
S
Marino
P
P
Citro
C
C
Salvatoni
A
A
Vandenplas
Y
Y
D001706:Biopsy; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D017097:Electric Impedance; D004884:Eructation; D050782:Esophageal pH Monitoring; D004941:Esophagitis / Q000453:epidemiology / Q000209:etiology / Q000503:physiopathology*; D004947:Esophagus / Q000473:pathology* / Q000503:physiopathology; D005260:Female; D005764:Gastroesophageal Reflux / Q000150:complications*; D006801:Humans; D006863:Hydrogen-Ion Concentration; D008297:Male; D011446:Prospective Studies; D012016:Reference Values