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Esophageal impedance and esophagitis in children: any correlation?

S Salvatore1, B Hauser, T Devreker

  • 1Clinica Pediatrica, Università dell'Insubria, Varese, Italy.

Journal of Pediatric Gastroenterology and Nutrition
|October 13, 2009
PubMed

Insights

Multiple intraluminal esophageal impedance and pH (MII-pH) testing in children with reflux disease did not clearly predict esophageal inflammation. The study found no significant differences in reflux types between children with and without esophagitis.

Area of Science:

  • Pediatric Gastroenterology
  • Gastrointestinal Motility Disorders
  • Esophageal Physiology

Background:

  • Gastroesophageal reflux disease (GERD) is common in children.
  • Esophageal histology is the gold standard for diagnosing GERD-related esophagitis.
  • Multiple intraluminal esophageal impedance and pH (MII-pH) monitoring is used to assess reflux in children.

Purpose of the Study:

  • To correlate MII-pH findings with esophageal histology in children suspected of GERD.
  • To evaluate the utility of MII-pH parameters in predicting esophageal mucosal injury.

Main Methods:

  • A prospective study analyzed MII-pH recordings and esophageal biopsies from 45 children.
  • Both automatic and manual MII-pH analysis were performed.
  • Automatic pH analysis included meal data.

Main Results:

  • Esophagitis was found in 56% of children.
  • Concordance between pH-study analysis and histology was 42%.
  • MII-pH showed higher mean/median pH and longer clearance times in children with esophagitis, but gas reflux was similar in both groups.

Conclusions:

  • MII-pH does not provide a distinct parameter to predict esophageal mucosal injury in children.
  • Acidic, weakly acidic, alkaline, and gas reflux were comparable in children with and without esophagitis.
  • Further research on clearance parameters is warranted.
Abstract

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