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[Alkaline gastroesophageal reflux. Diagnosis by double-channel pH measurement]
W Weilin1, I Eizaguirre, I Tapia
1Hospital N.S. Aranzazu, Universidad del País Vasco, San Sebastián.
Insights
Alkaline gastroesophageal reflux (AGER) may be more common in children than adults. Double pH monitoring effectively quantifies AGER, revealing its prevalence in pediatric patients.
Area of Science:
- Gastroenterology
- Pediatric Medicine
- Diagnostic Technology
Context:
- Alkaline gastroesophageal reflux (AGER) is well-documented in adults, but less understood in pediatric populations.
- Gastroesophageal reflux (GER) diagnosis in children often relies on limited data.
- Accurate quantification of reflux types is crucial for effective pediatric GER management.
Purpose:
- To quantify alkaline gastroesophageal reflux (AGER) in pediatric subjects using 24-hour double pH monitoring.
- To compare AGER prevalence and characteristics between refluxing and non-refluxing children.
- To evaluate the utility of double pH monitoring in differentiating reflux types.
Summary:
- A study involving 69 gastroesophageal reflux (GER) children and 40 controls utilized 24-hour double pH monitoring to assess AGER.
- GER cases were categorized into acid GER, mixed acid-alkaline GER, AGER, and
- silent
- GER.
- All groups exhibited prolonged periods of esophageal pH > 7, but acid and mixed GER groups showed greater acid exposure than AGER and silent GER groups.
Impact:
- Double pH monitoring offers superior quantification of alkaline reflux compared to single pH monitoring by identifying reflux origin.
- Findings suggest AGER may be more prevalent in pediatric populations than previously recognized.
- This study enhances understanding of pediatric GER subtypes and diagnostic capabilities.
Abstract:
Alkaline gastroesophageal reflux (AGER) has been documented in adult subjects, but few in pediatrics. 24-hours double pH-monitoring was performed in 40 nonrefluxers (control group) and 69 gastroesophageal reflux (RGE) children to quantify AGER. Esophageal phmetric variables were measured at 4 and 7 levels; gastric variables were measured at 4. Forty cases were classified into acid GER, 15 into acid alkaline GER (mixed), 8 into AGER, and 6, with clinical, manometric or endoscopic evidence of GER into "silent" GER. The acid and mixed GER groups had longer periods of acid exposure in esophagus than control, AGER and "silent" GER groups. All groups had long periods of pH > 7 in esophagus. In conclusion, the double gastroesophageal pH monitoring, by verifying the source of alkaline reflux into the esophagus had advantage of better quantifying alkaline reflux over single pH monitoring. AGER might be more frequent in pediatrics than adults.