Diagnostic modalities for Gastroesophageal Reflux

Patwari, A. K.; Bajaj, Pramila; Kashyp, Ravi; Anand, V. K.; Gangil, Ashutosh; Jain, Astha; Kapoor, Gaurav

doi:10.1007/bf02859372

Cited by 9 publications

(5 citation statements)

References 14 publications

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“…(27) It should however be noted that for this population, although attempts have been made, no ‘true’ normative values have been established because of the ethics of performing invasive studies in healthy infants and children. (75, 95) The authors found the RI measured by pH-metry had a sensitivity and specificity 50% and 82%, respectively, using history and physical examination as the gold standard method for diagnosing GERD.…”

Section: Question 3: What Diagnostic Interventions Have Additional Vamentioning

confidence: 99%

“…The last and most recent study used the Reflux Index (RI, defined as the percentage of time that pH < 4) to determine pathological GERD (where abnormal was defined as pH < 4 for >10% for infants <1 year and 5% infants >1 year) (27). It should however be noted that for this population, although attempts have been made, no ''true'' normative values have been established because of the ethics of performing invasive studies in healthy infants and children (75,95). The authors found the RI measured by pH-metry had a sensitivity and specificity 50% and 82%, respectively, using history and physical examination as the gold standard method for diagnosing GERD.…”

Section: Ph-metry/wireless Ph Recordingmentioning

confidence: 99%

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Pediatric Gastroesophageal Reflux Clinical Practice Guidelines

Rosen

Vandenplas

Singendonk

et al. 2018

J. pediatr. gastroenterol. nutr.

905

805

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This document serves as an update of the North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition (NASPGHAN) and the European Society for Pediatric Gastroenterology, Hepatology, and Nutrition (ESPGHAN) 2009 clinical guidelines for the diagnosis and management of gastroesophageal reflux disease (GERD) in infants and children and is intended to be applied in daily practice and as a basis for clinical trials. Eight clinical questions addressing diagnostic, therapeutic and prognostic topics were formulated. A systematic literature search was performed from October 1, 2008 (if the question was addressed by 2009 guidelines) or from inception to June 1, 2015 using Embase, MEDLINE, the Cochrane Database of Systematic Reviews and the Cochrane Central Register of Controlled Clinical Trials. The approach of the Grading of Recommendations Assessment, Development and Evaluation (GRADE) was applied to define and prioritize outcomes. For therapeutic questions, the quality of evidence was also assessed using GRADE. Grading the quality of evidence for other questions was performed according to the Quality Assessment of Studies of Diagnostic Accuracy (QUADAS) and Quality in Prognostic Studies (QUIPS) tools. During a 3-day consensus meeting, all recommendations were discussed and finalized. In cases where no randomized controlled trials (RCT; therapeutic questions) or diagnostic accuracy studies were available to support the recommendations, expert opinion was used. The group members voted on each recommendation, using the nominal voting technique. With this approach, recommendations regarding evaluation and management of infants and children with GERD to standardize and improve quality of care were formulated. Additionally, 2 algorithms were developed, 1 for infants <12 months of age and the other for older infants and children.

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Section: Question 3: What Diagnostic Interventions Have Additional Vamentioning

confidence: 99%

Section: Ph-metry/wireless Ph Recordingmentioning

confidence: 99%

Pediatric Gastroesophageal Reflux Clinical Practice Guidelines

Rosen

Vandenplas

Singendonk

et al. 2018

J. pediatr. gastroenterol. nutr.

905

805

View full text Add to dashboard Cite

show abstract

“…( 27) It should however be noted that for this population, although attempts have been made, no 'true' normative values have been established because of the ethics of performing invasive studies in healthy infants and children. (75,95) The authors found the RI measured by pH-metry had a sensitivity and specificity 50% and 82%, respectively, using history and physical examination as the gold standard method for diagnosing GERD.…”

Section: Ph-metry/wireless Ph Recordingmentioning

confidence: 99%

Pediatric Gastroesophageal Reflux Clinical Practice Guidelines: Joint Recommendations of the North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition (NASPGHAN) and the European Society for Pediatric Gastroenterology, Hepatology, and Nutrition (ESPGHAN)

Vandenplas

Rudolph

Lorenzo

et al. 2009

J. pediatr. gastroenterol. nutr.

677

807

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is an expert in gastroesophageal reflux disease and aerodigestive disorders. Yvan Vandenplas MD, PhD: YV is an expert in gastroesophageal reflux disease. Maartje Singendonk MD: MS is an expert in esophageal physiology. Michael Cabana MD: MC is a pediatrician with expertise in consensus guideline Carlo Di Lorenzo MD: CD is an expert in pediatric motility disorders and gastroesophageal reflux disease Frederic Gottrand MD: FG is an expert in esophagitis and gastroesophageal reflux disease Sandeep Gupta MD: SG is an expert in esophageal diseases. Miranda Langendam PhD: ML is aguideline methodologist Annamaria Staiano MD: AS is an expert in pediatric motility disorders and gastroesophageal reflux disease. Nikhil Thapar MD: NT is an expert in pediatric motility disorders. Neelesh Tipnis MD: NT is an expert in pediatric motility disorders. Merit Tabbers MD, PhD: MT is an expert in gastroesophageal reflux disease.

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“…It also entails a relatively low radiation burden. According to most studies, the sensitivity of gastro-esophageal scintigraphy for detection of GER in comparison to pH monitoring ranges from 60% to 90% [4], specificity is over 90% [5] [6].…”

Section: Discussionmentioning

confidence: 99%

Sensitivity of Esophageal Scintigraphy (Milk Scans) in Detecting Gastro-Esophageal Reflux

Bafaraj¹,

Alzahrani²

2015

OJMI

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Gastro-esophageal scintigraphy (milk scan) is an accurate technique for detecting gastro-esophageal reflux that can be performed rapidly with minimal patient discomfort. A retrospective study was performed to find out to how much radionuclide milk scan is sensitive for detecting gastroesophageal reflux (GER) for 89 patients who subjected to milk scan within Years 2010 to 2013. The study group age is ranging from one month old to four years old. Milk scan was performed using PHILIPS and SEIMENS machine. Tc 99-m sulfur colloid with milk administrated orally or through nasogastric tube to the patient. The highest frequency for milk scan study was in age group of 0-6 months old with 77% positive finding. Patients who suffer repeated vomiting represented the highest reason of examination for milk scan (46% of overall cases), while chocking attacks, pulmonary aspiration, and congenital heart disease, were 26%, 16%, 12% respectively of the overall cases. Seventy-nine percent of patients who prepared to be examine using nasogastric tube found with positive finding, 50% of GER patients have abnormal tracer activity in the mid of esophagus; on the other hand, 50% of GER patients divided equally between the lower and upper esophagus. The study show that infants especially in age of 0-6 months old and with repeated vomiting symptoms are strongly recommended to milk scan study rather than fluoroscopy to avoid unnecessary dose to the patients.

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Diagnostic modalities for Gastroesophageal Reflux

Abstract: Our results suggest that a combination of diagnostic modalities may be required to diagnose GER in young children. Ambulatory 24 hour pH monitoring appears to be the single best investigation and combining it with EB and/or GS can help to detect maximum number of cases.

Cited by 9 publications

References 14 publications

Pediatric Gastroesophageal Reflux Clinical Practice Guidelines

Pediatric Gastroesophageal Reflux Clinical Practice Guidelines

Pediatric Gastroesophageal Reflux Clinical Practice Guidelines: Joint Recommendations of the North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition (NASPGHAN) and the European Society for Pediatric Gastroenterology, Hepatology, and Nutrition (ESPGHAN)

Sensitivity of Esophageal Scintigraphy (Milk Scans) in Detecting Gastro-Esophageal Reflux

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