Related Experiment Video

Updated: Aug 30, 2026

Simultaneous Laryngopharyngeal and Conventional Esophageal pH Monitoring
06:46

Simultaneous Laryngopharyngeal and Conventional Esophageal pH Monitoring

Published on: December 14, 2020

Circadian variation of gastroesophageal reflux in children

Steven J Steiner1, Joseph M Croffie, Sandeep K Gupta

  • 1Department of Pediatrics, James Whitcomb Riley Hospital for Children, Indiana University School of Medicine, Indianapolis, Indiana 46202-5225, USA.

Digestive Diseases and Sciences
|October 17, 2003
PubMed

Insights

Infants with gastroesophageal reflux show a distinct daily pattern, with peak reflux occurring in the mid-afternoon. Understanding this circadian variation is key for effective antireflux therapy targeting specific times.

Area of Science:

  • Pediatrics
  • Gastroenterology
  • Circadian Biology

Background:

  • Gastroesophageal reflux (GER) is common in infants.
  • Previous observations suggest peak reflux occurs in the mid-afternoon for both asymptomatic and symptomatic infants.
  • The diurnal pattern of GER requires further investigation.

Purpose of the Study:

  • To investigate the circadian variation of gastroesophageal reflux in children.
  • To compare reflux patterns in children with normal versus abnormal 24-hour esophageal pH probe studies.

Main Methods:

  • Studied 87 pediatric patients using 24-hour esophageal pH monitoring.
  • Analyzed circadian patterns of reflux index in patients with normal and abnormal pH probe results.

Main Results:

  • Fifteen patients (17%) had abnormal pH studies (reflux index >4%) and showed significant circadian variation.
  • Peak reflux in abnormal cases occurred mid-afternoon (mean 12.60%) and at night (mean 8.07%), with troughs in the early morning (mean 2.60%).
  • Seventy-two patients with normal studies exhibited less variation, with early morning peaks (mean 1.76%).

Conclusions:

  • Gastroesophageal reflux in children exhibits significant circadian variation, particularly in those with abnormal pH studies.
  • Mid-afternoon represents a peak time for reflux events in affected children.
  • Antireflux therapies should be timed to coincide with periods of highest reflux activity.

More Related Videos

Construction of a Wireless-Enabled Endoscopically Implantable Sensor for pH Monitoring with Zero-Bias Schottky Diode-based Receiver08:25

Construction of a Wireless-Enabled Endoscopically Implantable Sensor for pH Monitoring with Zero-Bias Schottky Diode-based Receiver

Published on: August 27, 2021

Surgical Models of Gastroesophageal Reflux with Mice05:19

Surgical Models of Gastroesophageal Reflux with Mice

Published on: August 25, 2015

Related Concept Videos

Gastroesophageal Reflux Disease01:25

Gastroesophageal Reflux Disease

Gastroesophageal reflux disease (GERD) is the backward flow of stomach contents (acid, pepsin, or bile) into the esophagus, causing mucosal inflammation known as esophagitis. It results from failure of antireflux mechanisms, mainly the lower esophageal sphincter (LES), influenced by mechanical and physiological factors.Etiology and Risk FactorsGERD develops when LES function is weakened or when intra-abdominal pressure increases. Risk factors include aging, obesity, and sliding hiatal hernia,...
Gastroesophageal Reflux Disease I: Meaning and Pathophysiology01:29

Gastroesophageal Reflux Disease I: Meaning and Pathophysiology

Gastroesophageal Reflux Disease (GERD) involves the recurrent backflow of the stomach or duodenal contents into the esophagus, leading to troublesome symptoms and potential esophageal mucosal damage. Although GERD is often referred to as a disease, it is more accurately described as a syndrome, as it encompasses a range of symptoms and complications rather than a singular pathological entity, impacting a large number of individuals as the most prevalent upper gastrointestinal problem. Roughly...
Gastroesophageal Reflux Disease II: Clinical Features and Management01:29

Gastroesophageal Reflux Disease II: Clinical Features and Management

Gastroesophageal reflux disease, or GERD, is a persistent medical condition that affects many individuals worldwide. Its clinical manifestations can vary greatly, making diagnosis and management challenging for healthcare professionals. The following is a comprehensive overview of the clinical manifestations, assessment, and management strategies for GERD.
Clinical Manifestations
GERD presents itself in a multitude of ways, with symptoms varying from person to person. The hallmark symptoms are...
Esophageal Achalasia01:27

Esophageal Achalasia

Esophageal achalasia is a chronic neurogenic disorder characterized by impaired relaxation of the lower esophageal sphincter (LES) and absent or ineffective peristalsis in the distal esophagus. This leads to a functional obstruction without a physical blockage, despite significant disruption of esophageal motility.EtiologyAchalasia is caused by degeneration of the myenteric (Auerbach's) plexus, specifically the loss of inhibitory ganglion cells that produce vasoactive intestinal peptide (VIP)...
Hiatal Hernia01:25

Hiatal Hernia

A hiatal hernia is the abnormal protrusion of the stomach or other abdominal organs through the esophageal hiatus of the diaphragm into the thoracic cavity.Normally, the gastroesophageal junction (GEJ) lies below the diaphragm and is supported by the phrenoesophageal membrane, the diaphragmatic crura, and connective tissues. Weakening of these structures—due to aging, congenital defects like a short esophagus, or increased intra-abdominal pressure from coughing, obesity, pregnancy, or heavy...
Esophageal Strictures-I: Introduction01:30

Esophageal Strictures-I: Introduction

Esophageal strictures involve abnormal narrowing or tightening of the esophagus. They vary in length and severity, ranging from mild constriction to complete obstruction, and are classified as benign (noncancerous) or malignant (cancerous).
Etiology
The primary cause of esophageal strictures is long-standing gastroesophageal reflux disease (GERD), accounting for about 70 to 80% of adult cases. Chronic acid reflux can lead to injury and scarring of the esophageal lining, culminating in...