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Updated: Aug 9, 2026

Simultaneous Laryngopharyngeal and Conventional Esophageal pH Monitoring
Published on: December 14, 2020
Diurnal variation in intragastric pH in children with and without peptic ulcers
Insights
Intragastric pH monitoring in children reveals distinct patterns in peptic ulcer disease. Gastric ulcer patients show reduced acidity, while duodenal ulcer patients exhibit adult-level acidity, differing from healthy children.
Area of Science:
- Pediatric Gastroenterology
- Gastrointestinal Physiology
- Peptic Ulcer Disease
Background:
- Diurnal intragastric pH variation in pediatric peptic ulcer disease is uncharacterized.
- Understanding gastric acidity in children with ulcers is crucial for diagnosis and management.
Purpose of the Study:
- To investigate the diurnal intragastric pH profiles in children with gastric and duodenal ulcers.
- To compare gastric acidity between children with ulcers and healthy controls.
Main Methods:
- 24-hour intragastric pH monitoring using a monopolar glass electrode in 82 subjects.
- Analysis included children with gastric ulcers, duodenal ulcers, non-ulcer controls, and healthy adults.
- Calculated percent of readings below pH 2, 3, 4, and 5, comparing means and age-related slopes between groups.
Main Results:
- In healthy children, gastric acidity increased with age, reaching adult levels by 14 years.
- Children with gastric ulcers had lower mean intragastric acidity than age-adjusted controls (p < 0.05).
- Children with duodenal ulcers had significantly higher mean time below pH 2 compared to controls (p = 0.002), with acidity at or above adult levels.
Conclusions:
- Pediatric gastric ulcers are associated with reduced gastric acidity during childhood.
- Pediatric duodenal ulcers present with gastric acidity levels comparable to or exceeding adult levels.
- Age-related changes in gastric acidity differ between children with gastric and duodenal ulcers.
Abstract:
Diurnal variation in intragastric pH in children with peptic ulcers has not been previously reported. Therefore, we monitored intragastric pH during a 24-h period in 82 subjects (10 children with gastric ulcers, 9 children with duodenal ulcers, 58 non-ulcer (comparison group) children, and 5 healthy adults) using a monopolar glass pH electrode. The percent of readings below pH 2, 3, 4, and 5 for each subject was calculated and compared between the comparison group and the two ulcer groups using means and slopes (i.e. changes in percent with age for each group) of percent readings for each pH analysis. In the comparison group children, gastric acidity increased with age and reached adult levels by 14 y. Mean readings for all pH analyses in gastric ulcer children were lower than those in age-adjusted comparison children (p < 0.05). The slopes of the relationships between age and the percent time below any pH for the gastric ulcer group were different from those in the comparison group (p < 0.05) and were negative for all pH analyses. The mean time below pH 2 in children with duodenal ulcers was greater than that in age-adjusted comparison children (p = 0.002). The slope of the relationship between age and the percent time below pH 2 in the duodenal ulcer group was different from that in the comparison group (p < 0.05). Gastric acidity in children with primary gastric ulcers was reduced during childhood, but in children with primary duodenal ulcer, gastric acidity was at or above adult levels.
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