Abstract
24 hour esophageal pH monitoring is currently considered to be the most sensitive diagnostic technique for gastroesophageal reflux (GER) in infants & children. Present instrument configurations limit this technique to hospitalized patients. Portable computer-controlled equipment which permits performance of ambulatory 24 hr. pH monitoring in adults & children has been developed.
Outpatient 24 hr. pH monitoring was performed in 24 children (ages 6 wks-14 yrs) for suspected GER. The pH electrode was placed in the distal esophagus 3-4 cm proximal to the lower esophageal sphincter. All patients received a regular diet or formula; acidic juices (pH less than 4.0) were avoided. 21 completed studies (18 hrs or longer) were scored using accepted criteria for hospitalized patients. 15/21 studies were considered +; 6/21 showed insignificant GER. The 24 hr. pH studies were compared to other outpatient diagnostic tests (UGI, Tc99m milk scan) in each case:
All patients tolerated the procedure without complications, but premature electrode dislodgement was observed in 4 infants.
Conclusions: Outpatient 24 hr. esophageal pH monitoring may be safely performed in infants & children. In an unsupervised, ambulatory setting, this test appears to be a sensitive study for the diagnosis of significant GER.
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Cannon, R. AMBULATORY 24 HOUR ESOPHAGEAL pH MONITORING IN INFANTS AND CHILDREN. Pediatr Res 18 (Suppl 4), 192 (1984). https://doi.org/10.1203/00006450-198404001-00592
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DOI: https://doi.org/10.1203/00006450-198404001-00592