Rachel Rosen1, Candace Lord, Samuel Nurko. 1. Center for Motility and Functional Gastrointestinal Disorders, Division of Gastroenterology and Nutrition, Children's Hospital-Boston, Harvard Medical School, 300 Longwood Avenue, Boston, MA 02115, USA.
Abstract
BACKGROUND & AIMS: Multichannel intraluminal impedance (MII) has been incorporated into gastroesophageal reflux evaluations in children despite a lack of evidence comparing it to the gold standard pH probe. The aim of this study was to compare these two technologies. METHODS: Twenty-five consecutive, untreated children undergoing pH-MII recording were studied. Sensitivities for the pH probe and MII were defined as: (acid+pH-only episodes)/(acid+non-acid+pH-only episodes) and (acid+non-acid episodes)/(acid+non-acid+pH-only episodes), respectively. Sensitivities were compared using paired t testing. After the analysis was performed, the pH-MII tracings of 25 age-matched children taking acid suppression therapy were compared and sensitivity calculations were performed. RESULTS: In untreated patients, 1845 reflux episodes were detected, and 1702 were detected in treated patients. The mean sensitivities of pH probe and MII in untreated patients were 80.6 +/- 18.2% and 76.1 +/- 13.5%, respectively (P = .41). The mean sensitivities of pH probe and MII in treated patients were 47.2 +/- 36.0% and 80.3 +/- 21.1%, respectively (P = .005). Twenty-five percent of reflux episodes were pH-only episodes. There were no differences in the mean number of acid or non-acid reflux episodes in patients with normal and abnormal pH probe studies. Instead, there were significantly more pH-only episodes in patients with abnormal probe studies. CONCLUSIONS: The sensitivity of MII equals that of the pH probe in untreated patients but is superior to the pH probe in treated patients. pH-only episodes are numerous in pediatrics and should be included in pH-MII analyses.
BACKGROUND & AIMS: Multichannel intraluminal impedance (MII) has been incorporated into gastroesophageal reflux evaluations in children despite a lack of evidence comparing it to the gold standard pH probe. The aim of this study was to compare these two technologies. METHODS: Twenty-five consecutive, untreated children undergoing pH-MII recording were studied. Sensitivities for the pH probe and MII were defined as: (acid+pH-only episodes)/(acid+non-acid+pH-only episodes) and (acid+non-acid episodes)/(acid+non-acid+pH-only episodes), respectively. Sensitivities were compared using paired t testing. After the analysis was performed, the pH-MII tracings of 25 age-matched children taking acid suppression therapy were compared and sensitivity calculations were performed. RESULTS: In untreated patients, 1845 reflux episodes were detected, and 1702 were detected in treated patients. The mean sensitivities of pH probe and MII in untreated patients were 80.6 +/- 18.2% and 76.1 +/- 13.5%, respectively (P = .41). The mean sensitivities of pH probe and MII in treated patients were 47.2 +/- 36.0% and 80.3 +/- 21.1%, respectively (P = .005). Twenty-five percent of reflux episodes were pH-only episodes. There were no differences in the mean number of acid or non-acid reflux episodes in patients with normal and abnormal pH probe studies. Instead, there were significantly more pH-only episodes in patients with abnormal probe studies. CONCLUSIONS: The sensitivity of MII equals that of the pH probe in untreated patients but is superior to the pH probe in treated patients. pH-only episodes are numerous in pediatrics and should be included in pH-MII analyses.
Authors: Hayat Mousa; Rodrigo Machado; Marina Orsi; Catherine S Chao; Tala Alhajj; Mark Alhajj; Courtney Port; Beth Skaggs; Frederick W Woodley Journal: Curr Gastroenterol Rep Date: 2014-08
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