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Updated: Mar 14, 2026
Simultaneous Laryngopharyngeal and Conventional Esophageal pH Monitoring
Published on: December 14, 2020
Reflux monitoring in children
M M J Singendonk1, M A Benninga2, M P van Wijk2,3
1Department of Pediatric Gastroenterology and Nutrition, Emma Children's Hospital AMC, Amsterdam, The Netherlands. m.m.j.singendonk@amc.uva.nl.
Insights
Multichannel intraluminal impedance (MII) monitoring, combined with pH monitoring, aids in diagnosing gastroesophageal reflux (GER) in children. This method detects acid and non-acid reflux, improving GERD evaluation.
Area of Science:
- Pediatric Gastroenterology
- Diagnostic Technology
Background:
- Gastroesophageal reflux (GER) evaluation in children traditionally relies on esophageal pH monitoring.
- Multichannel intraluminal impedance (MII) monitoring offers enhanced detection of both acid and non-acid reflux events, including liquid and gas.
- Combined 24-hour pH-MII monitoring is increasingly recommended for diagnosing GERD and correlating reflux with symptoms in pediatric populations.
Purpose of the Study:
- To assess the utility of combined 24-hour pH-MII monitoring in evaluating pediatric patients with symptoms suggestive of GERD.
- To determine the role of pH-MII monitoring in predicting the presence of reflux esophagitis in children.
Main Methods:
- Utilized combined 24-hour pH-MII monitoring in pediatric patients presenting with gastrointestinal symptoms.
- Analyzed impedance and pH data to characterize reflux events (acidic, non-acidic, liquid, gas).
Main Results:
- New evidence supports the effectiveness of pH-MII monitoring in evaluating children with GERD-like symptoms.
- pH-MII monitoring demonstrates potential in predicting the presence of reflux esophagitis.
Conclusions:
- Combined pH-MII monitoring is a valuable tool for assessing GER and GERD in children.
- Clinical application of pH-MII monitoring requires careful consideration of specific factors and interpretation nuances.
Abstract:
Recently, multichannel intraluminal impedance (MII) monitoring was added to the repertoire of tests to evaluate the (patho)physiology of gastroesophageal reflux (GER) in children. Its advantage above the sole monitoring of the esophageal pH lies in the ability of the detection of both acid and nonacid GER and to discern between liquid and gas GER. Currently, combined 24 h pH-MII monitoring is recommended for evaluation of gastro-esophageal reflux disease (GERD) and its relation to symptoms in infants and children, despite the lack of reference values in these age groups. There is new evidence in the current issue of this Journal supporting the role of pH-MII monitoring for the evaluation of children presenting with gastrointestinal symptoms suggestive of GERD and the prediction of the presence of reflux esophagitis. However, several issues should be taken into account when performing pH-MII clinically.
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