Principles of Combined Esophageal Impedance-ph Monitoring in Children: Indications, Benefits and Limitations
نویسندگان
چکیده
The standard test for suspected gastroesophageal refl ux is pH monitoring. However, the majority of gastroesophageal refl ux episodes in infants and children are nonacidic (pH > 4) and extraesophageal symptoms apparently can be caused by both acidic (pH < 4) and nonacidic refl ux. In order to overcome these aspects, a new technique has been developed and placed under scrutiny in the past twenty years: multichannel intraluminal impedance. Combined with standard pH recording, it provides more information than simple pH measurement because it allows the study of non-acid refl ux and the temporal association between symptoms and nonacid refl ux. Data can be analyzed for bolus composition (gas, fl uid, solid) and refl ux height, duration, and clearance. Although normal values for the pediatric population are not yet available, combined multichannel intraluminal impedance and pH measurement has the potential to become the new “gold standard” for gastroesophageal refl ux testing.
منابع مشابه
Indications, methodology, and interpretation of combined esophageal impedance-pH monitoring in children: ESPGHAN EURO-PIG standard protocol.
AIM The aim of the study was to provide an updated position statement from the ESPGHAN European Pediatric Impedance Working Group on different technical aspects such as indications, methodology, and interpretation of multichannel intraluminal impedance-pH monitoring (MII-pH). METHODS Evidence was used where available, but the article is based mainly on expert opinion and consensus. RESULTS ...
متن کاملEsophageal pH and Combined Impedance-pH Monitoring in Children
Esophageal pH monitoring is considered the gold standard for the diagnosis of gastroesophageal reflux disease because of the normal ranges across the pediatric age range. However, this method can only detect acid reflux. Multichannel intraluminal impedance-pH (MII-pH) monitoring has recently been used for the detection of bolus reflux in infants and children. This method allows for the detectio...
متن کاملAchalasia Previously Diagnosed as Gastroesophageal Reflux Disease by Relying on Esophageal Impedance-pH Monitoring: Use of High-Resolution Esophageal Manometry in Children
Gastroesophageal reflux disorder (GERD) is the most common esophageal disorder in children. Achalasia occurs less commonly but has similar symptoms to GERD. A nine-year old boy presented with vomiting, heartburn, and nocturnal cough. The esophageal impedance-pH monitor revealed nonacidic GERD (all-refluxate clearance percent time of 20.9%). His symptoms persisted despite medical treatment for G...
متن کاملUse of Esophageal Impedance beyond Diagnosis of GERD
Combined multichannel intraesophageal impedance-pH (MII-pH) monitoring is currently the the gold standard method to diagnosis of gastroesophageal reflux disease (GERD). A standard MII-pH catheter has six pairs of impedance electrodes. Multiple impedance-measuring within the esophagus allows determination of direction of bolus movement within the esophagus. So that MII is used as a good esophage...
متن کاملDiagnostic difficulties during combined multichannel intraluminal impedance and pH monitoring in patients with esophagitis or Barrett's esophagus.
Gastroesophageal reflux disease (GERD) is one of the most common esophageal diseases in developed countries. It is widely believed that GERD symptoms are caused by acid refluxate within the esophagus, so ambulatory 24 hour pH-monitoring became the gold standard in detecting gastroesophageal reflux. Traditional ambulatory pH monitoring is unable to detect a gastroesophageal reflux with pH >4. Th...
متن کامل