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Ph and impedance in children

Miguel Couselo, Vicente Ibáñez, Javier Lluna, Juan José Vila
Introduction Low values of esophageal impedance baseline (EIB) have been related to esophagitis. The aim of this study was to evaluate the diagnostic performance of EIB for erosive esophagitis (ErE) and histological esophagitis (HiE) in children studied for gastroesophageal reflux. Material and Methods Children who underwent esophageal multichannel intraluminal impedance-pH monitoring (MII-pH) and upper-endoscopy with esophageal biopsies were studied retrospectively. EIB values were obtained by MII-pH. ErE was assessed by endoscopy following the Hetzel-Dent classification; HiE was defined by basal zone hyperplasia, papillary lengthening, or inflammatory infiltration...
October 21, 2016: European Journal of Pediatric Surgery
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
Ivan Pavić, Irena Babić, Jasna Čepin Bogović, Iva Hojsak
OBJECTIVE: The aim of this study was to investigate the diagnostic usefulness of combined multichannel intraluminal impedance-pH (MII-pH) monitoring in children with suspected laryngopharyngeal reflux (LPR). DESIGN, SETTING AND PARTICIPANTS: A prospective study including children in whom, due to LPR suggestive symptoms, MII-pH monitoring was performed at tertiary medical center from February 2012 to July 2015. INTERVENTIONS: All included children underwent same diagnostic protocol which included examination by single pulmonologist, ENT specialist and underwent 24-h MII-pH monitoring...
October 11, 2016: Clinical Otolaryngology
M M J Singendonk, M A Benninga, M P van Wijk
Recently, multichannel intraluminal impedance (MII) monitoring was added to the repertoire of tests to evaluate the (patho)physiology of gastroesophageal reflux (GER) in children. Its advantage above the sole monitoring of the esophageal pH lies in the ability of the detection of both acid and nonacid GER and to discern between liquid and gas GER. Currently, combined 24 h pH-MII monitoring is recommended for evaluation of gastro-esophageal reflux disease (GERD) and its relation to symptoms in infants and children, despite the lack of reference values in these age groups...
October 2016: Neurogastroenterology and Motility: the Official Journal of the European Gastrointestinal Motility Society
Mark Safe, Jemma Cho, Usha Krishnan
OBJECTIVE: The aim of the study was to evaluate and compare multichannel intraluminal impedance-pH (MII-pH) monitoring with standard investigations including pH testing for detecting gastroesophageal reflux disease (GERD) in children. METHODS: A retrospective review of all MII-pH studies performed between July 2007 and March 2013 at Sydney Children's Hospital. Results from MII-pH testing, esophagogastroduodenoscopy (EGD), barium meal and pepsin assay, symptoms, underlying comorbidities, age, and medication usage were evaluated...
November 2016: Journal of Pediatric Gastroenterology and Nutrition
Fei Dy, Janine Amirault, Paul D Mitchell, Rachel Rosen
OBJECTIVES: To determine the sensitivity of salivary pepsin compared with multichannel intraluminal impedance with pH testing (pH-MII), endoscopy, and gastroesophageal reflux disease (GERD) questionnaires. STUDY DESIGN: We prospectively recruited 50 children from Boston Children's Hospital who were undergoing pH-MII to evaluate for GERD. The patients completed 24-hour pH-MII testing, completed symptom and quality of life questionnaires, and provided a saliva specimen that was analyzed using the PepTest lateral flow test...
October 2016: Journal of Pediatrics
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
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
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
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
N F Rinsma, F A Mauritz, L W E van Heurn, C E J Sloots, P D Siersema, R H J Houwen, D C van der Zee, A A M Masclee, J M Conchillo, M Y A Van Herwaarden-Lindeboom
BACKGROUND: Laparoscopic antireflux surgery (LARS) is a well-established treatment option for children with proton pomp inhibitor (PPI)-resistant gastroesophageal reflux disease (GERD). Besides preventing reflux of gastric fluid and solid content, LARS may also impair the ability of the stomach to vent intragastric air (i.e. gastric belching) and induce gas-related complications, such as bloating and/or hyperflatulence. Furthermore, it was previously hypothesized that LARS induces a behavioral type of belching, not originating from the stomach, called supragastric belching...
October 2016: Neurogastroenterology and Motility: the Official Journal of the European Gastrointestinal Motility Society
I Hojsak, L Ivković, T Trbojević, I Pavić, O Jadrešin, Z Mišak, S Kolaček
BACKGROUND: The aim of this study was to determine the role of multichannel intraluminal impedance-pH (pH-MII) monitoring in the diagnosis of gastro-esophageal reflux disease (GERD) in children who presented with gastrointestinal (GI) symptoms in comparison with the results of pH-metry alone and endoscopy. METHODS: All children who underwent pH-MII monitoring due to GI symptoms, suggestive of GERD, from October 2013 to October 2015 in Children's Hospital Zagreb, were retrospectively enrolled in the study...
October 2016: Neurogastroenterology and Motility: the Official Journal of the European Gastrointestinal Motility Society
M A Dziekiewicz, K Karolewska-Bochenek, Ł Dembiński, A Gawronska, K Krenke, J Lange, M Banasiuk, E Kuchar, M Kulus, P Albrecht, A Banaszkiewicz
Gastroesophageal reflux disease is common in adult patients with interstitial lung disease. However, no data currently exist regarding the prevalence and characteristics of the disease in pediatric patients with interstitial lung disease. The aim of the present study was to prospectively assess the incidence of gastroesophageal reflux disease and characterize its features in children with interstitial lung disease. Gastroesophageal reflux disease was established based on 24 h pH-impedance monitoring (MII-pH)...
2016: Advances in Experimental Medicine and Biology
Rodrigo Strehl Machado, Frederick W Woodley, Beth Skaggs, Carlo Di Lorenzo, Ihuoma Eneli, Mark Splaingard, Hayat Mousa
PURPOSE: This study was performed to evaluate the quality of sleep in snoring obese children without obstructive sleep apnea (OSA); and to study the possible relationship between sleep interruption and gastroesophageal reflux (GER) in snoring obese children. METHODS: Study subjects included 13 snoring obese children who were referred to our sleep lab for possible sleep-disordered breathing. Patients underwent multichannel intraluminal impedance and esophageal pH monitoring with simultaneous polysomnography...
March 2016: Pediatric Gastroenterology, Hepatology & Nutrition
F Van Ginderdeuren, E Kerckhofs, M Deneyer, S Vanlaethem, R Buyl, Y Vandenplas
OBJECTIVES: To determine the influence of physiotherapy using intrapulmonary percussive ventilation on gastro-oesophageal reflux (GOR) in infants <1 year. METHODS: In this controlled trial with intra-subject design, children were studied using multichannel intraluminal impedance pH (pH-MII) monitoring over 24 hr, during which they received one 20-min session of intrapulmonary percussive ventilation in upright position (IPVR ), 2 hr after their latest feeding...
February 24, 2016: Pediatric Pulmonology
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
Jernej Brecelj, Nina Zidar, Jera Jeruc, Rok Orel
OBJECTIVES: The aim of the study was to investigate morphological and functional characteristics of oesophageal epithelial barrier in children with cystic fibrosis (CF) with or without gastro-oesophageal reflux disease (GORD) in comparison to healthy controls. METHODS: Oesophagogastroduodenoscopy with oesophageal biopsies and combined oesophageal multichannel intraluminal impedance-pH monitoring was performed in 17 children with CF (CFtot) with (CFgord) or without GORD (CFnorm)...
May 2016: Journal of Pediatric Gastroenterology and Nutrition
Yu-Wen Liu, Jia-Feng Wu, Huey-Ling Chen, Hong-Yuan Hsu, Mei-Hwei Chang, Wei-Chung Hsu, Ping-Huei Tseng, Hsiu-Po Wang, Yen-Hsuan Ni
BACKGROUND: Gastroesophageal reflux (GER) is the retrograde flow of gastric contents into the esophagus and may induce a variety of complications. Endoscopically visible breaks in the distal esophageal mucosa are the most reliable evidence of reflux esophagitis. Combined multichannel intraluminal impedance and pH-metry (MII-pH) is a technique that enables monitoring of GER independent of its acidity. The aim of this study is to investigate the GER patterns in children with the aid of MII-pH monitoring and determine the correlation between endoscopically proven reflux esophagitis and reflux types by MII-pH monitoring...
December 23, 2015: Pediatrics and Neonatology
Daniel R Duncan, Janine Amirault, Nikki Johnston, Paul Mitchell, Kara Larson, Rachel L Rosen
OBJECTIVES: Gastroesophageal reflux is common but remains a controversial disease to diagnose and treat and little is known about the role of reflux testing in predicting clinical outcomes, particularly in children at risk for extraesophageal reflux complications. The aim of this study was to determine if rates of hospitalization were affected by reflux burden even after adjusting for aspiration risk. METHODS: We prospectively recruited, between 2009 and 2014, a cohort of pediatric patients with suspected extraesophageal reflux disease who were referred for reflux testing and underwent both multichannel intraluminal impedance with pH (pH-MII) and modified barium swallow studies...
August 2016: Journal of Pediatric Gastroenterology and Nutrition
Bruno Hauser, Jean De Schepper, Anne Malfroot, Elke De Wachter, Iris De Schutter, Kathelijn Keymolen, Yvan Vandenplas
BACKGROUND: Gastro-oesophageal reflux (GOR) is common in patients with cystic fibrosis (CF). The aim of this study was to investigate the relationship between gastric emptying (GE) and GOR in children with CF. METHODS: Multichannel intraluminal impedance-pH monitoring (MII-pH) to measure GOR and GE breath test (GEBT) to measure GE were performed in 28 children with symptoms suggestive for GOR disease (GORD) (group 1). GEBT was performed in another 28 children with/without GOR symptoms who agreed to undergo GEBT but not MII-pH (group 2)...
July 2016: Journal of Cystic Fibrosis: Official Journal of the European Cystic Fibrosis Society
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