Predictive value of oesophageal pH variables in children with gastro-oesophageal reflux

Area of Science:

• Pediatric Gastroenterology
• Diagnostic Medicine

Background:

• Gastro-oesophageal reflux (GOR) is a common condition in children.
• Accurate prediction of GOR outcomes is crucial for effective management.

Purpose of the Study:

• To evaluate the predictive value of 24-hour esophageal pH monitoring for clinical outcomes in children with suspected or confirmed GOR.
• To identify key pH study parameters that correlate with long-term GOR prognosis.

Main Methods:

• Sixty-three pediatric patients with suspected or confirmed GOR underwent 24-hour esophageal pH studies.
• Patients were followed for at least one year to assess clinical progress.
• Non-parametric statistical analysis was used to determine the significance of pH recording variables.

Main Results:

• Sleep reflux (minutes/hour) and acid clearing time were highly significant predictors (p < 0.0005 and p < 0.0001, respectively).
• Sleep GOR > 6.4 min/hr or acid clearing time ≥ 7 minutes predicted clinical outcome with 88.1% specificity and 81.0% sensitivity.
• False positive results were more common in infants under 10 months.

Conclusions:

• 24-hour esophageal pH monitoring provides valuable prognostic information for pediatric GOR.
• Specific thresholds for sleep reflux and acid clearing time can reliably predict clinical outcomes.
• Caution is advised when interpreting positive pH study results in infants under 10 months due to a higher rate of false positives.