Related Experiment Videos
Ambulatory esophageal pH monitoring in children as an indicator for surgery
Insights
Twenty-four-hour esophageal pH monitoring aids in diagnosing gastroesophageal reflux in children. It helps identify patients who may not benefit from medical therapy, guiding surgical decisions.
Area of Science:
- Pediatric Gastroenterology
- Diagnostic Technologies
Background:
- Gastroesophageal reflux (GER) is a common condition in children.
- Accurate diagnosis is crucial for effective management.
Purpose of the Study:
- To evaluate the utility of 24-hour esophageal pH monitoring in diagnosing GER in symptomatic children.
- To assess the role of pH monitoring in guiding treatment decisions, including surgery.
Main Methods:
- Fifty-nine children with GER symptoms underwent 24-hour esophageal pH monitoring.
- Patients with significant reflux were treated with cimetidine, Gaviscon, and Nestargel.
- Repeat pH monitoring and clinical assessment guided further management.
Main Results:
- Significant reflux was diagnosed in 44% of patients.
- Children who did not improve with medical therapy showed higher pretreatment reflux index (26.5) compared to those who improved (11.2).
- Five children underwent antireflux surgery after failing medical management.
Conclusions:
- Esophageal pH monitoring is valuable for diagnosing GER in children.
- pH monitoring assists in selecting appropriate candidates for antireflux surgery.
- Ambulatory and home monitoring offer convenient and cost-effective diagnostic solutions.
Abstract:
Twenty-four-hour esophageal pH monitoring was performed in 59 children with symptoms of gastroesophageal reflux using a miniature pH electrode and a portable recording system to establish the diagnosis. Significant reflux was seen in 26 (44%) of the patients and these were treated for six weeks with cimetidine, Gaviscon, and Nestargel. Five children who did not improve either symptomatically or on repeat pH monitoring while on treatment underwent antireflux surgery. The pretreatment reflux index in this group was 26.5 compared with a pretreatment reflux index of 11.2 in the 21 patients who improved on therapy (P less than 0.01). Esophageal pH monitoring has enabled selection of children for surgery and may be used as an early indicator of those who will not benefit from long-term medical therapy. Ambulatory and home monitoring techniques are more convenient and cost-effective and allow studies to be performed in the normal home environment.