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Diagnostic modalities for gastro-esophageal reflux in infantile wheezers

Soumya Patra1, Varinder Singh, Jagdish Chandra

  • 1Department of Pediatrics, Lady Hardinge Medical College & Kalawati Saran Children's Hospital, New Delhi, India. dr_soumyapatra@rediffmail.com

Journal of Tropical Pediatrics
|July 3, 2010
PubMed

Insights

Gastro-intestinal (GI) scintiscan demonstrates higher sensitivity and specificity than 24-h pH study for diagnosing gastro-esophageal reflux (GER) in infantile wheezers. GI scintiscan is recommended as a primary diagnostic tool for GER in young children with wheezing symptoms.

Area of Science:

  • Pediatric Gastroenterology
  • Diagnostic Imaging
  • Respiratory Medicine

Background:

  • Gastro-esophageal reflux (GER) is a common concern in infantile wheezers.
  • Accurate diagnosis of GER is crucial for effective management of wheezing in infants.
  • Comparing diagnostic modalities for GER is essential for clinical practice.

Purpose of the Study:

  • To compare the diagnostic accuracy of Gastro-intestinal (GI) scintiscan and 24-h pH study in detecting GER among infantile wheezers.
  • To evaluate the utility of these diagnostic tools in children under two years of age.
  • To determine the preferred diagnostic method for GER in this population.

Main Methods:

  • A study involving 52 children under two years of age with wheezing symptoms.
  • Both GI scintiscan and 24-h pH study were performed on all participants to assess for GER.
  • Diagnostic performance was evaluated against clinical history and response to anti-reflux treatment.

Main Results:

  • Gastro-esophageal reflux (GER) was detected in approximately 45% of the studied infantile wheezers.
  • The highest agreement between GI scintiscan and 24-h pH study was observed in infants aged 7-12 months (κ = 0.591).
  • GI scintiscan exhibited superior sensitivity and specificity compared to the 24-h pH study (p ≤ .001).

Conclusions:

  • Both GER scan and 24-h pH study provide complementary information for diagnosing GER in infantile wheezers.
  • GI scintiscan is a more effective single diagnostic test for GER in early wheezers when both methods are available.
  • The findings support the use of GI scintiscan as a primary diagnostic tool for GER in this pediatric population.
Abstract

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