Results of multichannel intraluminal impedance pH metry in symptomathic children with normal pH metry findings

Abstract

Aim: A retrospective study was performed to evaluate the results of multichannel intraluminal impedance (MII) pH metry in symptomatic children with normal pH monitoring (PM) findings.

Patients and methods: Children who have reflux index (RI) less than 4% in PM and recurrent symptoms were included. All children underwent MII. Children who received antireflux treatment with normal PM findings were excluded from the study. MII results were evaluated for RI, content of reflux (acid, weak acid, and alkaline) number and type of impedance events, esophageal bolus clearance time and proximal extent of reflux (PER).

Results: Eight patients (age range: 5-13 years) were included to the study. The male female ratio was 5:3. The recurrent symptoms were related with gastrointestinal (n = 5) and upper respiratory system (n = 3). One of the patients was operated for esophageal atresia and one was followed for corrosive esophageal disease. Four of the patients had RI higher than 4% in MII. Patients with normal RI in MII, had weak acid reflux (n: 1), alkaline reflux (n = 1) and no reflux (n = 2). When number of impedance events evaluated, four patients had abnormal reflux episodes (70 or more reflux episodes). Impedance event recordings were correlated in 75% of PM findings. The content of impedance events were mixed and gas in nature. Prolonged esophageal clearance time and PER were detected in patients with chest pain and operated esophageal atresia.

Conclusion: MII can be considered as a superior diagnostic tool to detect weak acid and alkaline reflux in patients who had recurrent symptoms with normal PM studies. MII also provides information about bolus clearance time and extent of reflux.