Non acid gastroesophageal reflux episodes decrease with age as determined by multichannel intraluminal impedance-ph monitoring in symptomatic children

Autores

  • Marina Orsi Hospital Italiano, Servicio de Gastroenterología y Hepatología Infantil.
  • Judith Cohen-Sabban Hospital Italiano, Servicio de Gastroenterología y Hepatología Infantil.
  • Carlos Grandi Hospital Italiano, Servicio de Gastroenterología y Hepatología Infantil.
  • María Gabriela Donato Hospital Italiano, Servicio de Gastroenterología y Hepatología Infantil.
  • Carlos Lifschitz Hospital Italiano, Servicio de Gastroenterología y Hepatología Infantil.
  • Daniel D’Agostino Hospital Italiano, Servicio de Gastroenterología y Hepatología Infantil.

DOI:

https://doi.org/10.31053/1853.0605.v68.n1.21574

Palavras-chave:

gastroesophageal reflux, multichannel intraluminal impedance, non acid reflux, pH probe

Resumo

Objectives: To determine whether changes related to age in gastroesophageal reflux (GER) in infants and children are due to acid, non acid reflux or both, as determined by 24 hr pH probe (pH) and Multichannel Intraluminal Impedance (MII).
Methods: Tracings of simultaneous pH-MII from 243 infants and children who presented with either digestive or respiratory symptoms attributable to GER were reviewed and analyzed using Mann-Whitney U test.
Results: The number of GER episodes recorded was similar among children with predominantly gastrointestinal and those with respiratory symptoms. A significantly higher total number of GER episodes was observed by pH probe and MII in children under 22.8 mos of age compared with those who were older (median 159 vs. 110.5, p = 0.002). There was no significant change with age of acid reflux (AR) parameters. The changes observed were due to the significant decrease of non AR for all parameters measured, regardless of the presenting symptom.
Conclusions: The decrease in GER parameters that is observed after a mean of 22.8 mos. of age is at the expense of non AR. This finding may have an impact on the choice and results of therapeutic modalities in children versus that in infants.

Downloads

Não há dados estatísticos.

Referências

Nelson, S P, Chen, E, Syniar, G M, et al. Prevalence of symptoms of gastroesophageal reflux during infancy: a paediatric practice-based survey. Arch Pediatr Adolesc Med 1997;151:569 –572

Martin, J, Pratt, N, Declan Kennedy, J, et al. Natural History and Familial Relationships of Infant Spilling to 9 Years of Age. Pediatrics 2002;109:1061-1067

Skopnik, H, Silny, J, Heiber, O, et al. Gastroesophageal reflux in infants: evaluation of a new intraluminal impedance technique. J Pediatr Gastroenterol Nutr 1996; 23:591–598

Wenzl T. Invited review: investigating reflux with the intraluminal impedance technique. J Pediatr Gastroenterol Nutr 2002; 34:261–268

Rosen, R, Lord, C, Nurko, S. The sensitivity of multichannel intraluminal impedance and the pH probe in the evaluation of gastroesophageal reflux in children. Clin Gastroenterol Hepatol 2006; 4:167-172

Francavilla, R, Magistà, A M, Bucci, N, et al. Comparison of esophageal pH and multichanyounger nel intraluminal impedance testing in pediatric patients with suspected gastroesophageal reflux. J Pediatr Gastroenterol Nutr. 2010;50:154-60.

Shay, S, Tutuian, R, Sifrim, D, et al. Twenty-four hour ambulatory simultaneous impedance and pH monitoring: a multicenter report of normal values from 60 healthy volunteers. Am J Gastroenterol 2004; 99:1037–1043

Wiener, G J, Richter, J E, Copper, J B, et al. The symptom index: a clinically important parameter of ambulatory 24-hour esophageal pH monitoring. Am J Gastroenterol 1988;83:358–361

Vela, M F, Camacho-Lobato, L, Srinivasan, R, et al. Simultaneous intraesophageal impedance and pH measurement of acid and nonacid gastroesophageal reflux: effect of omeprazole. Gastroenterology 2001;120:1599–1608

Rosen, R, Nurko, S. The importance of multichannel intraluminal impedance in the evaluation of children with persistent respiratory symptoms. Am J Gastroenterol 2004;99:2452–2458

Vandenplas, Y, Rudolph, C D, Di Lorenzo, C, et al. 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) J Pediatr Gastroenterol Nutr 2009;49:498-547

Sondheimer, J M. Continuous monitoring of distal esophageal pH: a diagnostic test for gastroesophageal reflux in infants. J Pediatr 1980;96:804–807

Vandenplas, Y, Belli, D, Boige, N, et al. A standardized protocol for the methodology of esophageal pH monitoring and interpretation of the data for the diagnosis of gastroesophageal reflux. Statement of the European Society of Pediatric Gastroenterology and Nutrition (ESPGAN). J Pediatr Gastroenterol Nutr 1992;14:467–471

Campanozzi, A, Boccia, G, Pensabene, J, , et al. Prevalence and Natural History of Gastroesophageal Reflux: Pediatric Prospective Survey. Pediatrics 2009;123:779–783

Woodley, F W, Mousa, H. Acid gastroesophageal reflux reports in infants: a comparison of esophageal pH monitoring and multichannel intraluminal impedance measurements.Dig Dis Sci 2006;51:1910-1916

Condino, A A, Sondheimer, J, Pan, Z, et al. Evaluation of Infantile Acid and Nonacid Gastroesophageal Reflux Using Combined pH Monitoring and Impedance Measurement. J Pediatr Gastroenterol Nutr 2006;42:16–21

Dalby, K, Nielsen, R G, Markoew, S, et al. Reproducibility of 24-hour combined multiple intraluminal impedance (MII) and pH measurements in infants and children. Evaluation of a diagnostic procedure for gastroesophageal reflux disease. Dig Dis Sc 2007;52:2159-2165

Vandenplas, Y, Ashkenazi, A, Bell,i D, et al. A proposition for the diagnosis and treatment of gastro-oesophageal reflux disease in children: a report from a working group on gastro-oesophageal reflux disease. Working Group of the European Society of Paediatric Gastroenterology and Nutrition (ESPGAN). Eur J Pediatr. 1993;152:704-11

Salvatore, S, Arrigo, S, Luini, C, et al. Esophageal Impedance in Children: Symptom-Based Results. J Pediatr. 2010;157:949-954.e1-2

Nelson, S P, Chen, E, Syniar, G M, et al. Prevalence of symptoms of gastroesophageal reflux during infancy: a paediatric practice-based survey. Arch Pediatr Adolesc Med 1997;151:569 –572

Downloads

Publicado

2011-02-06

Como Citar

1.
Orsi M, Cohen-Sabban J, Grandi C, Donato MG, Lifschitz C, D’Agostino D. Non acid gastroesophageal reflux episodes decrease with age as determined by multichannel intraluminal impedance-ph monitoring in symptomatic children. Rev Fac Cien Med Univ Nac Cordoba [Internet]. 6º de fevereiro de 2011 [citado 17º de maio de 2024];68(1):8-13. Disponível em: https://revistas.unc.edu.ar/index.php/med/article/view/21574

Edição

Seção

Artículos Originales