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Pediatric esophagic impedance

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https://www.readbyqxmd.com/read/27736035/role-of-non-acid-gastro-esophageal-reflux-in-children-with-respiratory-symptoms
#1
Letizia Zenzeri, Paolo Quitadamo, Renato Tambucci, Dario Ummarino, Antonio Poziello, Erasmo Miele, Annamaria Staiano
OBJECTIVES: Respiratory symptoms are a possible atypical clinical picture of gastro-esophageal reflux disease (GERD). However, a significant number of patients with GERD-related respiratory symptoms do not report improvement despite aggressive acid-suppressive therapy. Some of these refractory cases may be due to the recently appreciated entity of non-acid or weakly acidic reflux. The aim of our study is to assess the pH-impedance features of GER inducing airway symptoms, compared with GER inducing typical gastro-intestinal (GI) symptoms...
October 13, 2016: Pediatric Pulmonology
https://www.readbyqxmd.com/read/27604397/pepsin-in-saliva-as-a-biomarker-for-oropharyngeal-reflux-compared-with-24-hour-esophageal-impedance-ph-monitoring-in-pediatric-patients
#2
J E Fortunato, R B D'Agostino, M O Lively
BACKGROUND: Pepsin in saliva is a proposed biomarker for oropharyngeal reflux. Pepsin may be prevalent in saliva from subjects with gastro-esophageal reflux and may correlate with proximal reflux by intraluminal impedance/pH monitoring (MII/pH). METHODS: Patients (3 days to 17.6 years, n=90) undergoing 24-hour MII/pH monitoring and asymptomatic controls (2 months to 13.7 years, n=43) were included. Salivary pepsin was determined using a pepsin enzyme-linked immunosorbent assay...
September 7, 2016: Neurogastroenterology and Motility: the Official Journal of the European Gastrointestinal Motility Society
https://www.readbyqxmd.com/read/27492870/pressure-flow-analysis-for-the-assessment-of-pediatric-oropharyngeal-dysphagia
#3
Lara Ferris, Nathalie Rommel, Sebastian Doeltgen, Ingrid Scholten, Stamatiki Kritas, Rammy Abu-Assi, Lisa McCall, Grace Seiboth, Katie Lowe, David Moore, Jenny Faulks, Taher Omari
OBJECTIVES: To determine which objective pressure-impedance measures of pharyngeal swallowing function correlated with clinically assessed severity of oropharyngeal dysphagia (OPD) symptoms. STUDY DESIGN: Forty-five children with OPD and 34 control children without OPD were recruited and up to 5 liquid bolus swallows were recorded with a solid-state high-resolution manometry with impedance catheter. Individual measures of pharyngeal and upper esophageal sphincter (UES) function and a swallow risk index composite score were derived for each swallow, and averaged data for patients with OPD were compared with those of control children without OPD...
October 2016: Journal of Pediatrics
https://www.readbyqxmd.com/read/27438415/combined-24-hours-esophageal-ph-monitoring-and-multichannel-intraluminal-impedance-for-comparison-of-gastroesophageal-reflux-in-children-with-typical-versus-atypical-symptoms-of-gastroesophageal-reflux-disease
#4
Seyed Mohsen Dehghani, Seyed Alireza Taghavi, Hazhir Javaherizadeh, Maryam Nasri
BACKGROUND: - Gastroesophageal reflux disease is the most common esophageal disorder in pediatrics. OBJECTIVE: - The aim of this study was to compare reflux parameters of typical and atypical symptoms of gastroesophageal reflux disease using 24-hour esophageal pH monitoring and multichannel intraluminal impedance in pediatric population. METHODS: - In this prospective study, 43 patients aged less than 18 year with suspected gastroesophageal reflux disease were enrolled...
July 2016: Arquivos de Gastroenterologia
https://www.readbyqxmd.com/read/27369283/effects-and-efficacy-of-laparoscopic-fundoplication-in-children-with-gerd-a-prospective-multicenter-study
#5
Femke A Mauritz, J M Conchillo, L W E van Heurn, P D Siersema, C E J Sloots, R H J Houwen, D C van der Zee, M Y A van Herwaarden-Lindeboom
INTRODUCTION: Laparoscopic antireflux surgery (LARS) in children primarily aims to decrease reflux events and reduce reflux symptoms in children with therapy-resistant gastroesophageal reflux disease (GERD). The aim was to objectively assess the effect and efficacy of LARS in pediatric GERD patients and to identify parameters associated with failure of LARS. METHODS: Twenty-five children with GERD [12 males, median age 6 (2-18) years] were included prospectively...
July 1, 2016: Surgical Endoscopy
https://www.readbyqxmd.com/read/27318379/esophageal-inlet-patch-an-under-recognized-cause-of-symptoms-in-children
#6
Giovanni Di Nardo, Cesare Cremon, Luca Bertelli, Salvatore Oliva, Roberto De Giorgio, Nico Pagano
OBJECTIVES: To determine the incidence of inlet patch (IP) and to assess the clinical and pathological features, role of the diagnostic workup in treatment decision making, efficacy of medical and endoscopic therapy, and natural history in a pediatric population. STUDY DESIGN: Consecutive patients aged <18 years (n = 1000) undergoing esophagogastroduodenoscopy were enrolled prospectively. Biopsy specimens were obtained from IPs and the proximal and distal esophagus, stomach, and duodenum...
September 2016: Journal of Pediatrics
https://www.readbyqxmd.com/read/27206156/supragastric-belching
#7
Joanne L S Ooi, Rukiye Vardar, Daniel Sifrim
PURPOSE OF REVIEW: Supragastric belching has recently gained recognition as a belching disorder of behavioral origin that can be accurately diagnosed on esophageal impedance monitoring. Its contribution to numerous other gastrointestinal disorders is beginning to be appreciated. Improved knowledge of its pathophysiology has enabled identification of therapeutic goals, some of which have been subject to formal study and demonstrated good outcomes. This review sets out to present and discuss new findings related to the improved understanding of the relationship between supragastric belching and other gastrointestinal disorders, as well as fresh concepts in terms of management...
July 2016: Current Opinion in Gastroenterology
https://www.readbyqxmd.com/read/27193974/laryngopharyngeal-reflux-in-children-with-chronic-otitis-media-with-effusion
#8
Anna Górecka-Tuteja, Izabela Jastrzębska, Jacek Składzień, Krzysztof Fyderek
BACKGROUND/AIMS: To evaluate the characteristic properties of laryngopharyngeal reflux (LPR) and gastroesophageal reflux (GER) in children with otitis media with effusion (OME) using 24-hour multichannel intraluminal impedance combined with dual-probe (pharyngeal and esophageal) pH-metry. METHODS: Children aged 7-10 years of age with OME underwent 24-hour multichannel intraluminal impedance pH-metry. The upper pH sensor was situated 1 cm above the upper esophageal sphincter, and the lower pH sensor was placed 3-5 cm above the lower esophageal sphincter...
July 30, 2016: Journal of Neurogastroenterology and Motility
https://www.readbyqxmd.com/read/26906020/laparoscopic-nissen-fundoplication-mainly-reduces-the-volume-of-acid-reflux-and-potentially-improves-mucosal-integrity-up-to-the-middle-esophagus-in-neurologically-impaired-children-detected-by-esophageal-combined-ph-multichannel-intraluminal-impedance-measurements
#9
Suguru Fukahori, Minoru Yagi, Shinji Ishii, Kimio Asagiri, Nobuyuki Saikusa, Naoki Hashizume, Motomu Yoshida, Daisuke Masui, Saki Sakamoto, Shihori Tsuruhisa, Tomohiro Kurahachi, Yoshiaki Tanaka
BACKGROUND: The aim of this study was to evaluate detailed changes of gastroesophageal reflux disease (GERD) in children before and after laparoscopic Nissen fundoplication (LNF) utilizing esophageal combined pH-multichannel intraluminal impedance (pH/MII) measurements. PATIENTS AND METHODS: Thirteen patients with neurological impairment, who received laparoscopic Nissen fundoplication (LNF) owing to refractory pathological GERD, were enrolled in this study. 24h pH/MII was conducted in all patients before and one year after LNF...
August 2016: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/26444666/congenital-esophageal-stenosis-diagnosed-in-an-infant-at-9-month-of-age
#10
F Savino, V Tarasco, S Viola, E Locatelli, M Sorrenti, A Barabino
Esophageal stenosis is a relatively uncommon condition in pediatrics and requires an accurate diagnostic approach. Here we report the case of a 9-month old female infant who presented intermittent vomiting, dysphagia and refusal of solid foods starting after weaning. She was treated for gastroesophageal reflux. At first, radiological investigation suggested achalasia, while esophagoscopy revelaed a severe congenital esophageal stenosis at the distal third of the esophagus. She underwent four endoscopic balloon dilatations that then allowed her to swallow solid food with intermittent mild dysphagia...
2015: Italian Journal of Pediatrics
https://www.readbyqxmd.com/read/26439568/pp-3-the-utility-of-integrated-relaxation-pressure-to-predict-achalasia-in-children
#11
T Ciecierega, C V Crawford, R Zarnegar, N A Tipnis
BACKGROUND: Esophageal High Resolution Manometry (eHRM) is a widely available technique to evaluate dysphagia symptoms in children. In adults, the 4 second integrated relaxation pressure (IRP4 s) has been used to characterize lower esophageal sphincter function and esophageal obstruction. To date, no study has evaluated the utility of the IRP to predict achalasia in children. AIMS: To determine the utility of the IRP4 s to predict achalasia in a cohort of children with achalasia...
October 2015: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/26437981/impaired-esophageal-motor-function-in-eosinophilic-esophagitis
#12
Cecilio Santander, Carlos M Chavarría-Herbozo, Irene Becerro-González, Diego Burgos-Santamaría
Eosinophilic esophagitis is a chronic immunoallergic inflammatory disease of the esophagus that represents a major cause of digestive morbidity among the pediatric and young adult populations. Despite the fact that key symptoms in adults include dysphagia and food impaction, many patients lack structural changes in the esophagus to account for their complaints, which suggests the presence of underlying motor disorders and esophageal distensibility impairment. In the last few years the esophageal motility of these patients has been studied using various approaches, most particularly high-resolution manometry, ambulatory manometry, and impedance planimetry...
October 2015: Revista Española de Enfermedades Digestivas
https://www.readbyqxmd.com/read/26309245/dysphagia-in-children-with-esophageal-atresia-current-diagnostic-options
#13
REVIEW
Maissa Rayyan, Karel Allegaert, Taher Omari, Nathalie Rommel
Dysphagia or swallowing disorder is very common (range, 15-52%) in patients with esophageal atresia. Children present with a wide range of symptoms. The most common diagnostic tools to evaluate esophageal dysphagia, such as upper barium study and manometry, aim to characterize anatomy and function of the esophageal body and the esophagogastric junction (EGJ). Using these technologies, a variety of pathological motor patterns have been identified in children with esophageal atresia. However, the most challenging part of diagnosing patients with esophageal dysphagia lies in the fact that these methods fail to link functional symptoms such as dysphagia with the esophageal motor disorders observed...
August 2015: European Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/26150122/impaired-esophageal-motor-function-in-eosinophilic-esophagitis
#14
Cecilio Santander, Carlos Miguel Chavarría Herbozo, Irene Becerro González, Diego Burgos Santamaría
Eosinophilic esophagitis is a chronic immunoallergic, inflammatory disease of the esophagus that represents a major cause of digestive morbidity among the pediatric and young adult populations. Despite the fact that key symptoms in adults include dysphagia and food impaction, many patients lack structural changes in the esophagus to account for their complaints, which suggests the presence of underlying motor disorders and esophageal distensibility impairment. In the last few years the esophageal motility of these patients has been studied using various approaches, most particularly high-resolution manometry, ambulatory manometry, and impedance planimetry...
July 6, 2015: Revista Española de Enfermedades Digestivas
https://www.readbyqxmd.com/read/26053592/esophageal-ph-monitoring-in-children-a-simple-mathematical-formula-for-ph-probe-positioning
#15
Jan K Nowak, Katarzyna Jonczyk-Potoczna, Daria M Adamczak, Aleksandra Lisowska, Jaroslaw Walkowiak
Correct pH probe placement is vital for the precision of esophageal pH monitoring. This study aimed at finding the optimal formula for placement of pH probe in the locus proposed by the European Society for Pediatric Gastroenterology, Hepatology, and Nutrition European Pediatric Impedance Working Group, that is, 2 vertebrae above the diaphragm. An analysis of data regarding 353 children ages 0-18 years in whom the position of the pH sensor was determined radiographically revealed that a mathematical formula (3...
August 2015: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/25820587/eosinophilic-laryngitis-in-children-with-aerodigestive-dysfunction
#16
Robert J Yawn, Sari Acra, Steven L Goudy, Raina Flores, Christopher T Wootten
OBJECTIVE: To describe the presence of laryngeal eosinophils and associated symptomatology in patients with aerodigestive dysfunction. STUDY DESIGN: Case series with chart review. SETTING: Single tertiary pediatric referral center. SUBJECTS: Eighty-one consecutive pediatric patients referred to a multidisciplinary aerodigestive clinic with upper airway concerns. METHODS: Microlaryngoscopy and posterior arytenoid biopsy, flexible bronchoscopy, esophagogastroduodenoscopy and esophageal biopsy, and impedance probe testing were performed as indicated by clinical symptoms...
July 2015: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/25756933/an-expert-panel-based-study-on-recognition-of-gastro-esophageal-reflux-in-difficult-esophageal-ph-impedance-tracings
#17
M J Smits, C M Loots, M P van Wijk, A J Bredenoord, M A Benninga, A J P M Smout
BACKGROUND: Despite existing criteria for scoring gastro-esophageal reflux (GER) in esophageal multichannel pH-impedance measurement (pH-I) tracings, inter- and intra-rater variability is large and agreement with automated analysis is poor. To identify parameters of difficult to analyze pH-I patterns and combine these into a statistical model that can identify GER episodes with an international consensus as gold standard. METHODS: Twenty-one experts from 10 countries were asked to mark GER presence for adult and pediatric pH-I patterns in an online pre-assessment...
May 2015: Neurogastroenterology and Motility: the Official Journal of the European Gastrointestinal Motility Society
https://www.readbyqxmd.com/read/25596103/pressure-flow-characteristics-of-normal-and-disordered-esophageal-motor-patterns
#18
Maartje M J Singendonk, Stamatiki Kritas, Charles Cock, Lara F Ferris, Lisa McCall, Nathalie Rommel, Michiel P van Wijk, Marc A Benninga, David Moore, Taher I Omari
OBJECTIVE: To perform pressure-flow analysis (PFA) in a cohort of pediatric patients who were referred for diagnostic manometric investigation. STUDY DESIGN: PFA was performed using purpose designed Matlab-based software. The pressure-flow index (PFI), a composite measure of bolus pressurization relative to flow and the impedance ratio, a measure of the extent of bolus clearance failure were calculated. RESULTS: Tracings of 76 pediatric patients (32 males; 9...
March 2015: Journal of Pediatrics
https://www.readbyqxmd.com/read/25272320/follow-up-after-ph-metry-and-ph-impedance-in-pediatric-gastroesophageal-reflux-disease
#19
Rachel J van der Pol, Marloes van den Ouweland, Clara M Loots, Yvan Vandenplas, Marc A Benninga, Michiel P van Wijk
OBJECTIVES: It is unclear how diagnostic tests for gastroesophageal reflux disease (GERD) in children relate to the course of symptoms during follow-up. METHODS: During 1 year, all children (ages 0-18 years), who underwent pH-metry and/or pH multichannel intraluminal impedance (MII), were included after written informed consent was obtained. pH-metry and pH-MII test characteristics, such as reflux index (RI, % time that esophageal pH < 4), were obtained from the measurements...
February 2015: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/25264213/the-sensitivity-of-acoustic-cough-recording-relative-to-intraesophageal-pressure-recording-and-patient-report-during-reflux-testing
#20
R Rosen, J Amirault, N Heinz, H Litman, U Khatwa
BACKGROUND: One of the primary indications for reflux testing with multichannel intraluminal impedance with pH (pH-MII) is to correlate reflux events with symptoms such as cough. Adult and pediatric studies have shown, using cough as a model, that patient report of symptoms is inaccurate. Unfortunately, intraesophageal pressure recording (IEPR) to record coughs is more invasive which limits its utility in children. The primary aim of this study was to validate the use of acoustic cough recording (ACR) during pH-MII testing...
November 2014: Neurogastroenterology and Motility: the Official Journal of the European Gastrointestinal Motility Society
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