[Reflux disease and 24-hour esophageal pH monitoring in children]

Area of Science:

• Pediatric Gastroenterology
• Diagnostic Techniques
• Gastrointestinal Motility Disorders

Context:

• Gastrooesophageal reflux disease (GERD) presents with diverse symptoms in children.
• Accurate diagnosis of GERD is essential for effective management.
• 24-hour esophageal pH monitoring is the established gold standard for GERD diagnosis.

Purpose:

• To evaluate the utility and safety of 24-hour esophageal pH monitoring in a pediatric population.
• To assess the clinical impact of pH monitoring results on patient management.
• To analyze the indications, success rates, and supplementary findings associated with pediatric pH monitoring.

Summary:

• 150 pH monitoring studies were conducted in 120 children (mean age 3.5 years).
• Common indications included regurgitation/vomiting (63%), failure to thrive (45%), and respiratory symptoms (32%).
• 44% of patients exhibited a pathological reflux index, and 66% received medical treatment based on findings. Endoscopy identified esophagitis in 11 of 20 children, while upper GI contrast series offered limited additional value.

Impact:

• 24-hour pH monitoring is a valuable diagnostic tool in pediatric gastroenterology.
• The procedure is safe, with a high success rate (91.7%) and no recorded complications.
• Findings from pH monitoring significantly influenced clinical decisions, including medical treatment and surgical interventions, highlighting its importance in pediatric care.