title: Esophageal multichannel intraluminal impedance and pH monitoring in children: indications and limits.
abstract: OBJECTIVE
  Aim of the study was to compare multichannel intraluminal impedance (MII)-pH monitoring versus pH only, as first-line assessment of gastroesophageal reflux (GER) in children and to define the relation between GER and symptoms as well relation between types of GER and age of children.
  
  
  METHODS
  All the patients with GER were divided in three groups: A, younger than 24 months, B, older than 24 months with typical symptoms and C, older than 24 months with atypical symptoms. The groups A and C underwent a combined MII-pH recording. The group B underwent a only pH recording. MII-pH measurements were performed in 89 children (63 group A and 26 group C), only pH measurements in 170 cases (group B).
  
  
  RESULTS
  Sixty-seven of the 247 pH measurements demonstrated abnormal reflux indices: 25.0% (group A), 28.8% (group B) and 20.8% (group C). The number of the reflux periods and the total reflux index were highest in the patients of the group B, but the number of long reflux periods was highest in the group C. Abnormal values at MII results were found in 36 cases: 41.7% in group A (high number of weakly acid refluxes events) and 45.8% in group C (similar number of acid and weakly acid events). The MII were considered pathological because of high number of reflux episodes and symptom index ≥ 50% respectively in 60.0% and 40.0% of the group A and 27.3% and 62.7% of the group C.
  
  
  CONCLUSIONS
  MII-pH study must be reserved to patients younger than 2-year old (high probability of weakly acid reflux) and children with atypical symptoms.
authors.affiliation: Pediatric Surgery Unit, Salesi Children Hospital Ospedali Riuniti Ancona, Ancona Italy - carmine.noviello@libero.it.
authors.forename: C
authors.initials: C
authors.lastname: Noviello
authors.forename: M
authors.initials: M
authors.lastname: Romano
authors.forename: F
authors.initials: F
authors.lastname: Mariscoli
authors.forename: F M
authors.initials: FM
authors.lastname: De Benedictis
authors.forename: A
authors.initials: A
authors.lastname: Martino
authors.forename: G
authors.initials: G
authors.lastname: Cobellis
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D017097:Electric Impedance; D050782:Esophageal pH Monitoring; D005260:Female; D005764:Gastroesophageal Reflux / Q000175:diagnosis* / Q000503:physiopathology; D006801:Humans; D006863:Hydrogen-Ion Concentration; D007223:Infant; D008297:Male; D011379:Prognosis; D012189:Retrospective Studies; D013997:Time Factors