Evaluation of esophageal motility using multichannel intraluminal impedance in healthy children and children with gastroesophageal reflux.
OBJECTIVE
Multichannel intraluminal impedance (MII) directly evaluates esophageal bolus transport. There is a good correlation between MII and manometry in healthy adults, but there are no reports concerning children.The aim of the present study was to determine normal values of esophageal motility using only impedance measurements in healthy children and in a pediatric population with gastroesophageal reflux (GER).


METHODS
We described in the present study 60 children submitted to pH-MII for 24 hours for suspected GER. Patients were divided into 2 different groups on the basis of their pH-MII report. Group 1 patients showed acid GER, whereas group 2 patients had negative pH-MII analysis for GER despite symptoms. We described impedance reflux and motility parameters on 10 standardized swallows: number of reflux, mean acid clearing time, median bolus clearing time, bolus presence time, total bolus transit time, segmental transit time, and total propagation velocity.


RESULTS
In group 1, the median mean acid clearing time was 151 seconds, whereas the median mean bolus clearing time was 25 seconds. In group 2 patients, all of the reflux parameters were normal. In group 1 the median bolus presence time at each measuring site, the median total bolus transit time, and the median segmental transit time were significantly greater and total propagation velocity lower than values reported in group 2 (P < 0.001), if compared with those described for adult patients.


CONCLUSIONS
The pH-MII is an ideal test in children because it studies GER with its characteristics and motility pattern. Our report summarizes for the first time impedance motility parameters in healthy children.
Pediatric Surgical Unit, Department of Mother and Child Care, University of Palermo, Palermo, Italy.
Maria Rita
MR
Di Pace
Anna Maria
AM
Caruso
Pieralba
P
Catalano
Alessandra
A
Casuccio
Enrico
E
De Grazia
D002648:Child; D002675:Child, Preschool; D017097:Electric Impedance; D004947:Esophagus / Q000502:physiology* / Q000503:physiopathology*; D005260:Female; D005764:Gastroesophageal Reflux / Q000503:physiopathology*; D005769:Gastrointestinal Motility / Q000502:physiology*; D005772:Gastrointestinal Transit / Q000502:physiology; D006801:Humans; D006863:Hydrogen-Ion Concentration; D008297:Male; D012016:Reference Values; D018709:Statistics, Nonparametric