The role of combined 24‐h multichannel intraluminal impedance‐<scp>pH</scp> monitoring in the evaluation of children with gastrointestinal symptoms suggesting gastro‐esophageal reflux disease

Hojsak, Iva; Ivković, L; Trbojević, Tena; Pavić, Ivan; Jadrešin, Oleg; Mišak, Zrinjka; Kolaček, Sanja

doi:10.1111/nmo.12846

Cited by 23 publications

(44 citation statements)

References 13 publications

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“…Hojsak et al showed that 52.3% children with GI symptoms and pathological pH-MII findings would not be identified by pH metry only, without significant differences between age groups (14). Another study indicated the lowest value of sensitivity in infants (59.4%), and the highest in children over 8 years (76.4%) (25).…”

Section: Combined Ph-mii Monitoring: Advantages and Disadvantagesmentioning

confidence: 98%

“…In the recommendations of European Society for Pediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN) and North American Society for Pediatric Gastroenterology, Hepatology and Nutrition (NASPGHAN), pH-MII monitoring has been recognized as a superior diagnostic method than conventional pH monitoring and it is recommended to be used, instead of pH monitoring in children (1). Afterwards, several studies have shown that combined pH-MII monitoring is a more sensitive method for detecting RE than pH monitoring alone (5,14). It is now clear that a significant percentage of RE in infants and children is weakly acidic, and that weakly-acid reflux causes symptoms (5,14,15).…”

Section: Combined Ph-mii Monitoring: Advantages and Disadvantagesmentioning

confidence: 99%

“…Afterwards, several studies have shown that combined pH-MII monitoring is a more sensitive method for detecting RE than pH monitoring alone (5,14). It is now clear that a significant percentage of RE in infants and children is weakly acidic, and that weakly-acid reflux causes symptoms (5,14,15). Therefore, pH-MII monitoring is the most accurate diagnostic method for the detection and characterization of GER in children and infants.…”

Section: Combined Ph-mii Monitoring: Advantages and Disadvantagesmentioning

confidence: 99%

“…Loots et al have defined a positive symptom association if SI and SSI are both positive or SAP is positive (17). Hojsak et al choose two out of three positive criteria (SI ≥50%, SSI ≥10%, SAP ≥95%) for defining MII abnormality (14).…”

Section: Combined Ph-mii Monitoring: Advantages and Disadvantagesmentioning

confidence: 99%

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The significance of different methods for detection of gastroesophageal reflux in children

Ristic¹,

Kisić-Tepavčević²,

Milovanović³

2018

Medicinski podmladak

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Symptom-based diagnosis of gastroesophageal reflux disease (GERD) is not specific due to high prevalence of disorders that can mimic GERD. Conventional pH monitoring, combined pH-MII (multiple intraluminal impedance) monitoring and esophagogastroduodenoscopy are diagnostic methods most frequently used in children.Combined pH-MII monitoring is the most accurate diagnostic method for detecting GERD in children, which tends to become the gold standard. In infants and probably in children with extraesophageal symptoms, MII gives the greatest contribution to the validity of pH-MII monitoring. High prevalence of functional heartburn, in children older than 8 years, suggests the importance of pH-MII monitoring in this age group as well. The majority of studies showed age differences in the chemical composition of refluxate. Weakly acid reflux is more common in infants and is often associated with symptoms, whereas acid reflux is more common in older children and adolescent. Sensitivity of endoscopy is very low compared to pH-MII monitoring as a reference test. Although endoscopy is the method of choice for the confirmation of reflux esophagitis, pH-MII parameters are promising indicators of mucosal integrity, but further studies are needed.The major problem with pH-MII monitoring is a lack of normative data for children. Therefore, the standardization is mandatory. For the present pH-MII monitoring has limited impact on treatment due to the absence of effective therapy for weakly acid reflux, suggesting that further studies should be directed in this direction.

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Section: Combined Ph-mii Monitoring: Advantages and Disadvantagesmentioning

confidence: 98%

Section: Combined Ph-mii Monitoring: Advantages and Disadvantagesmentioning

confidence: 99%

Section: Combined Ph-mii Monitoring: Advantages and Disadvantagesmentioning

confidence: 99%

Section: Combined Ph-mii Monitoring: Advantages and Disadvantagesmentioning

confidence: 99%

See 2 more Smart Citations

The significance of different methods for detection of gastroesophageal reflux in children

Ristic¹,

Kisić-Tepavčević²,

Milovanović³

2018

Medicinski podmladak

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“…This method detects reflux in the pH below 4, but GER episodes of weak acidity are not detected with this method. Neonates, infants and neurologically impaired children tend to have weak acid reflux because of the frequent feeding and neutralization of the gastric content following milk or formula [6][7][8] . Therefore, it is not possible to detect all reflux episodes with pH monitoring.…”

mentioning

confidence: 99%

Detection of gastroesophageal reflux in children with cerebral palsy using combined multichannel intraluminal impedance-ph procedure

et al. 2016

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Gastroesophageal reflux (GER) is a very common condition in children with neurological impairment and this can influence nutritional and respiratory outcomes. The aim of this study was to investigate the presence of GER in children with cerebral palsy (CP) using multiple intraluminal impedance (MII)-pH monitoring. The use of combined MII-pH allows for the detection of both acid and non-acid reflux episodes. A total of 29 CP patients with symptoms suggesting GER, aged 2 to 10 years old, underwent 24-hour combined MII-pH monitoring. There were a total of 3899 reflux episodes, of which 29% were acid, 60% were weakly acid and 11% were alkaline. The number of non-acid reflux episodes was statistically significantly greater (p<0.01). These findings confirm that GER disease is seen frequently in children with cerebral palsy and most of the reflux episodes are not acidic. Non-acid reflux can also influence the morbidity in patients with cerebral palsy. It can be concluded that 70% of the reflux episodes would not have been recognized by pH measurement alone.

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GER and Helicobacter pylori

Yücel

2022

Gastroesophageal Reflux in Children

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The role of combined 24‐h multichannel intraluminal impedance‐pH monitoring in the evaluation of children with gastrointestinal symptoms suggesting gastro‐esophageal reflux disease

Abstract: Compared with pH-metry alone, pH-MII performed significantly better in the detection of GERD in all age groups. On the basis of our data, pH-MII had a strong correlation with endoscopically confirmed esophagitis.

Cited by 23 publications

References 13 publications

The significance of different methods for detection of gastroesophageal reflux in children

The significance of different methods for detection of gastroesophageal reflux in children

Detection of gastroesophageal reflux in children with cerebral palsy using combined multichannel intraluminal impedance-ph procedure

GER and Helicobacter pylori

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