title: Combined esophageal intraluminal impedance, pH and skin conductance monitoring to detect discomfort in GERD infants.
abstract: BACKGROUND
  The clinical significance of weakly acidic reflux in infants is unclear. Skin conductance is a novel not-invasive method to evaluate discomfort. The aim of our study was to evaluate reflux-induced discomfort in infants with gastroesophageal reflux disease using simultaneously combined skin conductance and esophageal multichannel intraluminal impedance and pH monitoring.
  
  
  RESULTS
  Infants with gastroesophageal reflux symptoms were investigated for almost 20 hours divided into 120-second intervals. Temporal relationships between refluxes and discomfort were evaluated calculating the symptom association probability. Twelve infants aged 17-45 days were studied. Out of 194.38 hours of adequate artifact-free MII/pH and skin conductance monitoring, 584 reflux events were observed; 35.78% were positive for stress, of which 16.27% were acid and 83.73% weakly acidic. A significant association between refluxes and discomfort (p<0.05) was present in all infants. The intervals with reflux events showed increased skin conductance values compared to reflux-free intervals (p<0.001); SC values were similar for acid and weakly acidic reflux events.  CONCLUSION/SIGNFICANCE: Discomfort was significantly associated with reflux events and did not differ between weakly acidic and acid refluxes. Our results may raise concerns about the over-prescription use of antacid drugs in the management of gastroesophageal reflux symptoms in infancy.
authors.affiliation: Department of Pediatrics, University of Turin, S.Anna-Regina Margherita Children's Hospital, Turin, Italy. francesco.cresi@unito.it
authors.forename: Francesco
authors.initials: F
authors.lastname: Cresi
authors.forename: Emanuele
authors.initials: E
authors.lastname: Castagno
authors.forename: Hanne
authors.initials: H
authors.lastname: Storm
authors.forename: Leandra
authors.initials: L
authors.lastname: Silvestro
authors.forename: Roberto
authors.initials: R
authors.lastname: Miniero
authors.forename: Francesco
authors.initials: F
authors.lastname: Savino
mesh_terms: D017097:Electric Impedance; D004947:Esophagus; D005260:Female; D005712:Galvanic Skin Response; D005764:Gastroesophageal Reflux / Q000175:diagnosis* / Q000503:physiopathology*; D006801:Humans; D006863:Hydrogen-Ion Concentration; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D013997:Time Factors