[24-hour simultaneous esophagogastric pH-metry in children]

Twenty-four-hour pH-monitoring of the lower oesophagus is the best test for diagnosis of gastro-oesophageal reflux (GER) because it is the only one allowing its quantification. Unfortunately, it is limited by the fact that acid exposure is not the only mechanism by which GER harms the oesophagus. In the last 12 months we have introduced in our Institution simultaneous oeso-gastric pH-metering using a double-channel recorder and gastric and oesophageal electrodes. This procedure enables us to know when gastric pH turns alkaline because od diet, mucus, hypoacidity or duodeno-gastric reflux (DGR) to the point of making oesophageal pH-metering useless. We report 7 illustrative cases of GER with prolonged episodes of gastric alkalinization leading to oesophageal pH-metering false negatives. In the near future, double pH-metering will very probably modify our current interpretation of conventional tracings.