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Updated: Dec 4, 2025
Simultaneous Laryngopharyngeal and Conventional Esophageal pH Monitoring
Published on: December 14, 2020
Does Combined Multichannel Intraluminal Impedance and pH (MII-pH) Testing Improve Clinical Outcomes in Children With
Adrian L H Lee1,2, Vincent Varjavandi2,3, Daniel A Lemberg2,4
1Faculty of Medicine.
Insights
Multichannel intraluminal impedance and pH (MII-pH) testing significantly improves symptom and quality of life outcomes in children with gastroesophageal reflux disease (GERD). Treatment adjustments based on MII-pH results led to substantial improvements for over 98% of pediatric patients.
Area of Science:
- Pediatric Gastroenterology
- Diagnostic Testing
- Clinical Management
Background:
- Gastroesophageal reflux disease (GERD) is a common condition in children, often presenting with complex symptoms.
- Accurate diagnosis and effective management are crucial for improving quality of life in pediatric GERD patients.
- Multichannel intraluminal impedance and pH (MII-pH) testing offers a comprehensive method for evaluating esophageal acid and non-acid reflux.
Purpose of the Study:
- To assess the clinical utility of MII-pH testing in guiding treatment decisions for pediatric GERD.
- To evaluate the impact of MII-pH-guided therapy modifications on symptom severity and quality of life in children.
- To determine the effectiveness of MII-pH testing in managing pediatric patients with suspected GERD.
Main Methods:
- A cohort of pediatric patients (<18 years) referred for MII-pH testing at Sydney Children's Hospital were enrolled.
- Patients were categorized based on their acid suppression therapy (AST) status (on or off AST).
- Validated questionnaires assessed symptoms and quality of life at baseline and 4 weeks post-treatment changes, with scores compared.
Main Results:
- MII-pH testing prompted medication adjustments in 66.7% of patients (30 out of 45), regardless of baseline AST status.
- Specifically, 62.5% of patients off AST and 71.4% of patients on AST received treatment modifications.
- Over 98% of patients who underwent treatment changes based on MII-pH results experienced significant improvements in both symptoms and quality of life.
Conclusions:
- This study provides evidence for the clinical validity of MII-pH testing in the pediatric GERD population.
- MII-pH testing effectively guides clinical management, leading to significant symptom relief and enhanced quality of life in children.
- The findings support the use of MII-pH testing as a valuable tool for optimizing GERD treatment in pediatric patients.
Objectives:
The aim of the study was to investigate the role of combined multichannel intraluminal impedance and pH (MII-pH) testing in clinical management of children with gastroesophageal reflux disease (GERD) by exploring the impact of treatment changes made based on MII-pH testing results on symptoms and quality of life outcomes.
Methods:
All patients (<18 years) referred to the Sydney Children's Hospital for MII-pH testing were recruited. Patients were classified by acid suppression therapy (AST) status (on AST and off AST) and changes in medical and surgical management were evaluated. Validated questionnaires (Pediatric Gastroesophageal Symptom and Quality of Life Questionnaire and Infant Gastroesophageal Reflux Questionnaire Revised) were administered at baseline at the time of MII-pH testing, and 4 weeks after treatment changes were made and questionnaire scores were compared.
Results:
Of the 45 patients recruited, 24 patients (53.3%) were off AST and 21 patients (46.7%) were on AST. MII-pH testing led to medication changes in 30 patients (66.7%). This included 15 of 24 (62.5%) in those off AST and 15 of 21 (71.4%) in those on AST. More than 98% of patients who had treatment changes showed a significant improvement in both symptoms and quality of life scores.
Conclusions:
Our study is one of the first pediatric studies to evaluate the clinical validity of MII-pH testing in the pediatric population referred for suspected GERD, and its ability in guiding clinical management. Our study has shown that treatment decisions guided by and based on results of MII-pH testing led to a significant improvement in symptoms and quality of life in infants and children with GERD.
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