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Simultaneous Laryngopharyngeal and Conventional Esophageal pH Monitoring
06:46

Simultaneous Laryngopharyngeal and Conventional Esophageal pH Monitoring

Published on: December 14, 2020

Multipoint measurement of intragastric pH in healthy preterm infants

T I Omari1, G P Davidson

  • 1Centre for Paediatric and Adolescent Gastroenterology, Women's and Children's Hospital and Department of Paediatrics, University of Adelaide, Adelaide, South Australia. taher.omari@adelaide.edu.au

Archives of Disease in Childhood. Fetal and Neonatal Edition
|November 7, 2003
PubMed

Insights

Feeding has a smaller effect on gastric acidity and reflux in infants than previously thought. Multipoint pH monitoring reveals proximal stomach buffering is less significant, impacting diagnostic accuracy for gastro-oesophageal reflux disease.

Area of Science:

  • Pediatric Gastroenterology
  • Gastrointestinal Physiology
  • Neonatal Medicine

Background:

  • The diagnostic utility of 24-hour esophageal pH monitoring in infants is debated due to potential feed buffering of gastric acidity.
  • Accurate assessment of gastro-oesophageal reflux in neonates is crucial for timely diagnosis and management.

Purpose of the Study:

  • To reassess the influence of feeding on gastric pH and reflux events in infants.
  • To investigate the impact of feeding on gastric acid profiles using multipoint pH measurements.

Main Methods:

  • Simultaneous measurement of esophageal and intragastric pH at multiple levels (3, 6, 9 cm below LES) in 15 healthy premature infants.
  • A four-channel pH probe was used for four hours post-feeding to analyze pH parameters and reflux episodes.
  • Comparison of intragastric pH at different stomach levels and correlation with esophageal pH during reflux.

Main Results:

  • The proximal stomach exhibited significantly more buffering postprandially, taking longer to re-acidify compared to mid and distal stomach segments.
  • During gastro-oesophageal reflux episodes, esophageal nadir pH was lower than proximal gastric pH but consistently equal to or higher than distal gastric pH.
  • These findings suggest that feed buffering effects on gastric acidity may have been overestimated in prior studies.

Conclusions:

  • Multipoint pH monitoring provides a more nuanced understanding of gastric acid dynamics and reflux in infants.
  • The study challenges previous assumptions about the extent of feed buffering, potentially refining diagnostic criteria for infant reflux.
  • Revised interpretations of esophageal pH monitoring data may be warranted, considering regional gastric pH variations.
Abstract

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