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Updated: Feb 24, 2026
Gastrointestinal Motility Monitor GIMM
Published on: December 1, 2010
BSPGHAN Motility Working Group position statement: paediatric multichannel intraluminal pH impedance
Mohamed Mutalib1, David Rawat2, Keith Lindley3
1Paediatric Gastroenterology Department, Evelina London Children's Hospital, London, UK.
Insights
Combined pH-impedance monitoring is a valuable tool for diagnosing pediatric gastro-oesophageal reflux, but requires standardized guidelines due to variations in practice and high costs.
Area of Science:
- Pediatric Gastroenterology
- Gastrointestinal Motility Disorders
- Diagnostic Technologies
Background:
- Combined pH-impedance monitoring is preferred for diagnosing pediatric gastro-oesophageal reflux.
- It detects all reflux types (acid, weakly acidic, alkaline) and assesses symptom association.
- Limitations include lack of pediatric normal values and high costs.
Purpose of the Study:
- To establish a position statement on the indications and practical application of combined esophageal pH-impedance monitoring in children.
- Developed on behalf of the Motility Working Group of the British Society of Paediatric Gastroenterology, Hepatology and Nutrition.
Main Methods:
- Comprehensive review of current evidence.
- Synthesis of data to create practical guidelines.
Main Results:
- Provides a practical guide for clinicians on the indications, methods, and interpretation of results for pediatric multichannel intraluminal impedance pH (MII-pH) monitoring.
- Highlights the increasing use of MII-pH for diagnosing GERD and symptom association in children.
Conclusions:
- MII-pH is a growing diagnostic tool for pediatric gastro-oesophageal reflux disease (GERD) and symptom association.
- Significant variations in pediatric practice necessitate the standardization of MII-pH monitoring.
- Standardized guidelines are crucial for optimal and consistent application of MII-pH in pediatric care.
Background:
Combined pH-impedance monitoring has been suggested as the investigation of choice for diagnosing gastro-oesophageal reflux in children. Although it is superior to oesophageal pH monitoring in detecting all types of reflux episodes (acid, weakly acidic and alkaline) with the ability to evaluate symptom association with reflux events, it is still limited by the lack of true paediatric normal value and the high cost involved (equipment and personnel).
Objective:
To produce a position statement on behalf of the Motility Working Group of the British Society of Paediatric Gastroenterology, Hepatology and Nutrition on the indications and practical application of combined oesophageal pH-impedance monitoring in children.
Methods:
Up-to-date review of available evidence.
Results:
This document provides a practical guide to clinician on indications, methods and results interpretation of paediatric multichannel intraluminal impedance pH (MII-pH).
Conclusions:
MII-pH is increasingly used by paediatricians as the diagnostic tool for assessing gastro-oesophageal reflux disease and symptom association. There is wide variation in paediatric practice and a need for standardised practice.
