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Updated: Dec 11, 2025
Simultaneous Laryngopharyngeal and Conventional Esophageal pH Monitoring
Published on: December 14, 2020
Detection of reflux-symptom association in children with esophageal atresia by video-pH-impedance study
Settachote Maholarnkij1, Anapat Sanpavat2, Katawaetee Decharun3
1Department of Pediatrics, King Chulalongkorn Memorial Hospital and Faculty of Medicine, Chulalongkorn University, Bangkok 10330, Thailand.
Insights
Gastroesophageal reflux disease (GERD) is common in children with esophageal atresia (EA). Video multichannel intraluminal impedance-pH (MII-pH) testing is a valuable tool for diagnosing GERD in this population, showing a trend toward specific symptom associations.
Area of Science:
- Pediatric Gastroenterology
- Gastrointestinal Motility Disorders
- Congenital Malformations
Background:
- Children with esophageal atresia (EA) face a significant risk of developing gastroesophageal reflux disease (GERD).
- Early detection and management of GERD are crucial for improving outcomes in these patients.
- Reflux monitoring is essential for prompt intervention in children with EA.
Purpose of the Study:
- To evaluate the prevalence of GERD in children diagnosed with EA.
- To assess the association between specific symptoms and GERD in children with EA.
- To determine the diagnostic value of combined Video Multichannel Intraluminal Impedance and pH (MII-pH) study for GERD in this cohort.
Main Methods:
- A prospective study of 15 children with EA and suspected GERD was conducted.
- Esophagogastroduodenoscopy with biopsy and Video MII-pH study were performed concurrently.
- GERD symptoms were recorded via video monitoring, and abnormal reflux was identified using European Paediatric Impedance Group criteria.
Main Results:
- The study included 15 children (40% male, median age 3.1 years); 93.3% had EA type C.
- Symptom-reflux associations were observed for cough (45.7%), vomiting (89%), and irritability (71%).
- Abnormal endoscopic findings were present in 52.9%, esophagitis in 64.7%, and high reflux scores in 47.1% of patients.
Conclusions:
- The prevalence of GERD in children with EA is high.
- Video MII-pH study demonstrates high diagnostic value for GERD in children with EA.
- A trend towards specific symptom associations with GERD was noted in this population.
Background:
Children with esophageal atresia (EA) have risk of gastroesophageal reflux disease (GERD), suggesting reflux monitoring for prompt management.
Aim:
To evaluate GERD in children with EA and specific symptom association from combined Video with Multichannel Intraluminal Impedance and pH (MII-pH) study.
Methods:
Children diagnosed with EA with suspected GERD and followed up at King Chulalongkorn Memorial Hospital between January 2000 and December 2018 were prospectively studied. All underwent esophagogastroduodenoscopy with esophageal biopsy and Video MII-pH study on the same day. Symptoms of GERD which included both esophageal and extra-esophageal symptom were recorded from video monitoring and abnormal reflux from MII-pH study based on the statement from the European Paediatric Impedance Group. Prevalence of GERD was also reported by using histopathology as a gold standard. Endoscopic appearance was recorded using Los Angeles Classification and esophagitis severity was graded using Esohisto criteria.
Results:
Fifteen children were recruited with age of 3.1 (2.2, 9.8) years (40%, male) and the common type was C (93.3%). The symptoms recorded were cough (75.2%), vomiting (15.2%), irritability or unexplained crying (7.6%) and dysphagia (1.9%) with the symptom-reflux association of 45.7%, 89%, 71% and 0%, respectively. There were abnormal endoscopic appearance in 52.9%, esophagitis in 64.7% and high reflux score in 47.1%. Video MII-pH study has high diagnostic value with the sensitivity, specificity and accuracy of 72.7%, 100% and 82.4%, respectively.
Conclusion:
Prevalence of GERD in children with EA was high. Video MII-pH study to detect GERD in children with EA had high diagnostic value with the trend of specific symptom association.
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