Related Experiment Video
Updated: Jul 9, 2026
Simultaneous Laryngopharyngeal and Conventional Esophageal pH Monitoring
Published on: December 14, 2020
48-hour wireless oesophageal pH-monitoring in children: are two days better than one?
A Gunnarsdóttir1, P Stenström, E Arnbjörnsson
1Department of Paediatric Surgery, Lund University Hospital, Getingevägen 4, Lund, Sweden. anna.gunnarsdottir@med.lu.se
Insights
Twenty-four-hour wireless esophageal pH monitoring is sufficient for diagnosing gastroesophageal reflux in children. This method provides reliable results, reducing patient discomfort and allowing for a more normal daily routine.
Area of Science:
- Pediatric Gastroenterology
- Diagnostic Technologies
- Reflux Monitoring
Background:
- Wireless esophageal pH monitoring offers a less invasive alternative to traditional catheter-based systems.
- Current practice at the institution involves general anesthesia for capsule placement, limiting patient activity.
- The need to optimize monitoring duration for pediatric gastroesophageal reflux disease (GERD) diagnosis.
Purpose of the Study:
- To compare the diagnostic yield of 24-hour versus 48-hour wireless esophageal pH monitoring in children.
- To determine if a 24-hour measurement provides sufficient and reliable data for GERD assessment.
- To evaluate the feasibility and safety of extended wireless pH monitoring in pediatric patients.
Main Methods:
- A cohort of 24 children with symptomatic GERD underwent transoral placement of a wireless pH capsule.
- Esophageal acid exposure was monitored for 48 hours using a portable receiver.
- Data analysis included symptom registration and statistical comparison of 24-hour vs. 48-hour pH measurements and DeMeester scores.
Main Results:
- The wireless pH capsule was successfully placed in all patients with minimal technical issues.
- No statistically significant difference was found in median percentage time with pH < 4 or DeMeester scores between 24-hour and 48-hour monitoring periods.
- Individual variations in pH measurements were observed but generally lacked clinical significance.
Conclusions:
- Wireless ambulatory esophageal pH monitoring is a feasible, safe, and well-tolerated diagnostic tool for pediatric GERD.
- A 24-hour monitoring period using the wireless system provides sufficient and reliable data, comparable to 48-hour measurements.
- The study supports the adoption of 24-hour wireless esophageal pH monitoring to streamline diagnosis and improve patient experience.
Background:
Use of a catheter-free, radio telemetric, oesophageal pH-monitoring system in paediatric clinical practice allows patients to follow a more normal physiological pattern of activities and causes less discomfort. At our institution, placement of the capsule is done under general anaesthesia, which restricts the child's activity during the first day. The aim of this study was to determine whether oesophageal pH-measurements should be performed over 48 hours or whether 24-hour measurement provides sufficient and reliable results.
Children And Methods:
The study included 24 consecutive children with symptomatic gastro-oesophageal reflux problems who had undergone upper gastrointestinal endoscopies under general anaesthesia. The radio-transmitting Bravo capsule was introduced transorally and placed above the diaphragm at a width of two vertebral bodies. Oesophageal acid exposure was monitored via a portable receiver for 48 hours. The children's symptoms during measurements were registered. Wilcoxon signed rank test for paired samples was used after power analysis.
Results:
The capsule was successfully attached to the oesophageal mucosa in all cases with minor technical problems in only one patient. The 48-hour pH-monitoring was completed in 23 patients. The median percentage time with an oesophageal pH of less than 4 was 5.4 +/- 6.8 for the first 24 hours and 5.8 +/- 7.4 for the 48-hour measurement. The DeMeester score was 20.5 +/- 23.7 and 22.2 +/- 25.7, respectively.
Conclusions:
Ambulatory pH-monitoring using the wireless system is feasible and safe. It was well-tolerated by the children. There was no statistical difference between the pH-measurements or DeMeester scores during the first 24 hours compared with the 48-hour measurements. Individual variations were noted but had no clinical significance except in two patients. Our results support the use of pH-measurement for a period of 24 hours only.
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