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Acid gastroesophageal reflux in symptomatic infants is primarily a function of classic 2-phase and pH-only acid

Frederick W Woodley1, John Hayes, Hayat Mousa

  • 1Center for Advanced Research in Neuromuscular Gastrointestinal Disorders, Division of Gastroenterology, Hepatology, and Nutrition, 700 Children's Drive, Nationwide Children's Hospital, Columbus, OH 43205, USA. frederick.woodley@nationwidechildrens.org

Journal of Pediatric Gastroenterology and Nutrition
|May 5, 2009
PubMed

Insights

In infants with acid gastroesophageal reflux (AGER), classic 2-phase and pH-only events (POEs) are the primary drivers of reflux frequency and duration. These two AGER types account for most prolonged reflux episodes, impacting infant health.

Area of Science:

  • Gastroenterology
  • Pediatric Medicine
  • Diagnostic Technology

Background:

  • Combined esophageal pH monitoring (EPM) and multichannel intraluminal impedance (MII) identify four acid gastroesophageal reflux (AGER) types in infants: classic 2-phase, single-phase, pH-only events (POEs), and re-reflux.
  • The contribution of each AGER type to overall reflux frequency, acid reflux exposure time (ARET), and prolonged episodes (>5 minutes) remains unquantified.

Purpose of the Study:

  • To analyze the specific contributions of the four identified AGER types to reflux burden in symptomatic infants.
  • To determine which AGER types are most associated with prolonged reflux events.

Main Methods:

  • Analysis of EPM/MII tracings from 12 infants under 12 months of age with GER symptoms.
  • Quantification of the mean frequency, duration, and percentage of total ARET for each AGER type.
  • Assessment of the proportion of each AGER type that resulted in episodes lasting 5 minutes or longer.

Main Results:

  • Out of 926 total AGER events, classic 2-phase (23.1%) and POEs (69.2%) were the most frequent types.
  • Classic 2-phase and POEs accounted for the majority of ARET (52.3% and 42.4%, respectively).
  • Prolonged AGER episodes (>5 minutes) were predominantly classic 2-phase (57%) or POEs (37%).

Conclusions:

  • In symptomatic infants, the overall frequency and duration of acid gastroesophageal reflux are primarily determined by classic 2-phase and pH-only reflux events.
  • These findings highlight the significance of classic 2-phase and POEs in the pathophysiology of GER in infants.
Abstract

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