Abstract
The Tuttle Test, which directly measures gastric acid reflux, is the best method for detecting GER in adults. We used this test in 25 children (ages 4 wks.-16 yrs.) with GER symptoms to determine if this diagnostic tool was as useful in them and to learn if it was superior to cineesophagogram. Vomiting (20/25), retrosternal pain (9/25), weight<3%ile (8/25) and dysphagia (6/25) were the commonest symptoms. Skinner's technique was used with the following modifications: 1) the volume of-acid used was calculated by the formula (300ccs. 0.1N HC1/1.73 M2 :(X)cc./S.A. of patient. 2) the pH probe was placed orad to the lower esophageal sphincter (LES) at a position equal to 13% of the distance between the teeth and LES. Cineesophagrams were done in all patients. GER was seen in 3 but none of these children had positive Tuttle tests. One child with an esophageal stricture on cinestudy had a positive Tuttle test. Esophageal manometrics which evaluate LES function but do not detect GER were performed on all patients. Nineteen had normal LES pressures. Three of these had positive Tuttle Tests (reflux of acid). Five of 6 with decreased LES pressures had positive tests. The Tuttle test should be included in the diagnostic evaluation of all children with symptoms of GER because it has proven to be the most sensitive method for documenting gastric acid reflux in the pediatric age patient. 1. Skinner, D.B., Booth, D.J.:Ann. Surg. 172:627, 1970
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Euler, A., Ament, M. DETECTION OF GASTROESOPHAGEAL REFLUX (GER) IN THE PEDIATRIC AGE PATIENT BY ESOPHAGEAL INTRALUMINAL PH PROBE MEASUREMENT (TUTTLE TEST). Pediatr Res 11, 443 (1977). https://doi.org/10.1203/00006450-197704000-00442
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DOI: https://doi.org/10.1203/00006450-197704000-00442