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Updated: Dec 16, 2025
Simultaneous Laryngopharyngeal and Conventional Esophageal pH Monitoring
Published on: December 14, 2020
Multichannel Intraluminal Impedance and pH Monitoring: A Step Towards Pediatric Reference Values
Francesco Cresi1, Elena Andrea Cester1, Silvia Salvatore2
1Neonatology and Neonatal Intensive Care Unit, Department of Public Health and Pediatrics, University of Turin, Turin, Italy.
Insights
This study establishes reference values for multichannel intraluminal impedance and pH monitoring (MII/pH) in children, aiding accurate diagnosis of gastroesophageal reflux (GER). Findings correlate reflux events with age, improving pediatric GER disease assessment.
Area of Science:
- Pediatric Gastroenterology
- Diagnostic Technology
- Reflux Monitoring
Background:
- Multichannel intraluminal impedance and pH monitoring (MII/pH) is the gold standard for detecting gastroesophageal reflux (GER).
- Current MII/pH use is limited by a lack of established reference values for pediatric populations.
- Accurate GER diagnosis in children requires age- and condition-specific normative data.
Purpose of the Study:
- To establish reference values for MII/pH monitoring in a pediatric cohort.
- To investigate the correlation between MII/pH parameters, age, and meal status (postprandial/fasting).
- To provide normative data for improved diagnosis of pediatric GER disease.
Main Methods:
- Evaluation of MII/pH traces from 195 pediatric patients (newborns, infants, children) across three Italian hospitals.
- Exclusion of patients with significant symptom-reflux associations or pathological reflux index.
- Analysis of MII/pH data in entirety, and separately for postprandial and fasting periods.
Main Results:
- Age positively correlated with acidic GER events (r=0.37, P<0.05).
- Age negatively associated with weakly acidic GER events (r=0.46, P<0.05).
- Established distributions of MII/pH values for a pediatric population with normal GER exposure.
Conclusions:
- The study provides reference MII/pH values for pediatric GER assessment.
- These values can enhance the accuracy of GER disease diagnosis in children.
- Normative data supports better clinical interpretation of MII/pH findings in pediatric patients.
Background/Aims:
Combined multichannel intraluminal impedance and pH monitoring (MII/pH) is considered the most accurate test to detect gastroesophageal reflux (GER), however lacking reference values. We aim to determine reference values for the pediatric population and to correlate these values with age and postprandial/fasting period.
Methods:
We evaluated MII/pH traces from patients (newborns, infants, and children) admitted to 3 Italian hospitals and who underwent MII/ pH for suspected GER disease. Patients with MII/pH traces that showed significant symptom-reflux associations and/or a pathological reflux index (> 6% for newborns and infants, > 3% for children) were excluded. Traces were analysed in their entirety, and in the postprandial period (first hour after a meal) and the fasting period (the following hours before the next meal) separately.
Results:
A total of 195 patients (46 newborns, 83 infants, and 66 children) were included. Age positively correlated with frequency of acidic GER events (r = 0.37, P < 0.05) and negatively associated with weakly acidic GER events (r = 0.46, P < 0.05).
Conclusions:
This study describes the distribution of MII/pH values in a pediatric population with normally acidic GER exposure and no significant association between GER events and symptoms. These MII/pH values may be used as reference values in clinical practice for a corrected GER disease diagnosis in the pediatric population.
