title: Esophageal impedance in children: symptom-based results.
abstract: OBJECTIVE
  To correlate multiple intraluminal esophageal impedance recording with pH-monitoring with symptoms.
  
  
  METHODS
  Symptoms occurring within a 2-minute window of a reflux were considered to be associated with reflux. Analyses were performed in 1- to 6-, 6- to 12-, and >12-months-old patients for crying, pain, cough, and vomiting.
  
  
  RESULTS
  A total of 70 of 225 tracings were discarded. Of 2172 symptoms, 1136 (52%) were reflux-associated (45% acid reflux [AR], 51% weakly AR, 3% alkaline reflux). The strongest reflux-symptom association was found for vomiting. Cough-reflux association was higher in infants than in older children. In older patients, symptom-reflux association was more with AR. Symptoms were associated with proximal reflux in 70% of patients. The symptom index and symptom association probability (SAP) were positive (>50% for symptom index and >95% for SAP) for all refluxes in 83% and 46% of patients and for AR in 49% and 47% of patients, respectively. In 1- to 6-month-old infants, symptom index and SAP were higher for weakly AR than for AR. For crying, SAP was independent of AR or weakly AR. For cough, SAP was positive in one-third of patients, predominantly with AR in 6- to 12-month-old infants and with weakly AR in the other infants.
  
  
  CONCLUSIONS
  Multiple intraluminal esophageal impedance recording with pH-monitoring doubles the probability of documenting an association between symptoms and reflux compared with pH monitoring. In young infants, symptoms are more frequently associated with weakly AR than with AR.
authors.affiliation: Clinica Pediatrica, Università dell'Insubria, Varese, Italy.
authors.forename: Silvia
authors.initials: S
authors.lastname: Salvatore
authors.forename: Serena
authors.initials: S
authors.lastname: Arrigo
authors.forename: Carlo
authors.initials: C
authors.lastname: Luini
authors.forename: Yvan
authors.initials: Y
authors.lastname: Vandenplas
mesh_terms: D017097:Electric Impedance; D050782:Esophageal pH Monitoring; D005764:Gastroesophageal Reflux / Q000175:diagnosis*; D006801:Humans; D007223:Infant; D011446:Prospective Studies