Paediatric gastro-oesophageal reflux: prognostic indicators from pH monitoring
View abstract on PubMed
Summary
This summary is machine-generated.Gastro-oesophageal reflux (GOR) in children can be predicted using 24-hour pH monitoring. A threshold of 18% for percentage time pH < 4 shows prognostic value in identifying children needing surgery.
Area Of Science
- Pediatric Gastroenterology
- Diagnostic Medicine
- Reflux Monitoring
Background
- Gastro-oesophageal reflux (GOR) is common in children.
- Accurate diagnosis and prognosis are crucial for effective management.
- Predictive markers for treatment response in GOR are needed.
Purpose Of The Study
- To evaluate the prognostic value of 24-hour pH monitoring in children with GOR.
- To identify pH monitoring thresholds that predict the need for fundoplication.
- To differentiate prognostic indicators in primary versus secondary GOR.
Main Methods
- Retrospective review of 24-hour pH monitoring data from 57 children with GOR.
- Comparison of pH tracings between children who responded to medical treatment and those requiring fundoplication.
- Separate analysis for primary GOR and secondary GOR (due to other conditions).
Main Results
- For primary GOR, increased daytime reflux (21% vs 7% time pH < 4) predicted fundoplication need, with 18% threshold showing 92% specificity and 70% sensitivity.
- For secondary GOR, higher nighttime reflux (29% vs 3.7% time pH < 4) predicted fundoplication, with 18% threshold showing 80% specificity and 86% sensitivity.
- A percentage time pH < 4 greater than 18% served as a useful prognostic threshold.
Conclusions
- 24-hour pH monitoring data, both daytime and nighttime, have prognostic value in different pediatric GOR subgroups.
- Specific pH monitoring thresholds can help predict treatment outcomes and the need for surgical intervention.
- This analysis provides evidence for using pH monitoring as a predictive tool in pediatric GOR management.