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[Gastroesophageal reflux and respiratory pathology: a study comparing radiology and intraesophageal pH measurement]
M Cinquetti1, A Vinco, G Zoppi
1Cattedra di Pediatria, Università, Verona, Italia.
Insights
Barium esophagograms showed gastroesophageal reflux (GER) in children with respiratory symptoms, but 24-hour pH monitoring proved more sensitive. pH monitoring is crucial for diagnosing GER and assessing prognosis, as esophagograms can yield false negatives.
Area of Science:
- Pediatric Gastroenterology
- Respiratory Medicine
Background:
- Gastroesophageal reflux (GER) is a common cause of respiratory symptoms in children.
- Accurate diagnosis of GER is essential for effective management and prognosis.
Purpose of the Study:
- To evaluate the sensitivity of barium esophagograms and 24-hour intraesophageal pH monitoring in detecting gastric acid reflux in children.
- To assess the utility of these diagnostic tools as prognostic indicators for respiratory symptoms.
Main Methods:
- A cohort of 45 children with respiratory symptoms suggestive of GER underwent both barium esophagography and 24-hour intraesophageal pH monitoring.
- Data on diagnostic findings and patient outcomes were collected and analyzed.
Main Results:
- Barium esophagograms identified GER in 37 out of 45 patients.
- 24-hour intraesophageal pH monitoring confirmed GER in 39 out of 45 patients.
- A significant incidence of false-negative results was observed with barium esophagography when pH monitoring was positive.
Conclusions:
- 24-hour intraesophageal pH monitoring is a more sensitive diagnostic tool for detecting gastric acid reflux in children with respiratory symptoms compared to barium esophagography.
- pH monitoring is valuable for both diagnosis and prognosis in pediatric GER.
- Barium esophagography may underestimate the prevalence of GER, potentially leading to delayed or incorrect management.
Abstract:
From November 1st, 1992 to August 31st, 1993 45 children with respiratory symptoms of gastroesophageal reflux (GER) were tested with barium esophagogram and 24 h intraesophageal pH-monitoring to determine their sensitivity in detecting gastric acid reflux and to document their usefulness as a prognostic indicators. Results showed that thirty-seven of these patients had GER on esophagograms and that 24 h intraesophageal pH monitoring was positive in thirty-nine patients. However, we found a high incidence of false-negative results of the upper gastrointestinal series when the pH monitoring was positive.