Abstract
The original diagnostic 24 hour pH monitoring data in 57 children with gastro-oesophageal reflux (GOR) were retrospectively reviewed after a minimum of one year follow up. The tracings of children who responded to medical treatment were compared with those who failed to respond and required a fundoplication. Children with GOR secondary to oesophageal atresia/tracheo-oesophageal fistula and neurological conditions (n = 12) were analysed separately from those with primary GOR (n = 45). Children with primary GOR requiring a fundoplication (n = 9) had increased daytime reflux. The percentage time pH < 4 was the best discriminator (21% v 7%) with a threshold of 18% giving a 92% specificity and a 70% sensitivity. For children with secondary GOR the percentage time pH < 4 at night was significantly higher (29% v 3.7%) in those requiring a fundoplication (n = 5). A threshold of 18% gave an 80% specificity and an 86% sensitivity. These results show that both daytime and night time pH monitoring data can be of prognostic value in different subgroups of children with GOR. A percentage time pH < 4 of greater than 18% was a useful threshold to apply when evaluating the pH monitoring data.
Full text
PDF



Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Boyle J. T. Gastroesophageal reflux in the pediatric patient. Gastroenterol Clin North Am. 1989 Jun;18(2):315–337. [PubMed] [Google Scholar]
- Colson D. J., Campbell C. A., Wright V. A., Watson B. W. Predictive value of oesophageal pH variables in children with gastro-oesophageal reflux. Gut. 1990 Apr;31(4):370–373. doi: 10.1136/gut.31.4.370. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Cucchiara S., Staiano A., Gobio Casali L., Boccieri A., Paone F. M. Value of the 24 hour intraoesophageal pH monitoring in children. Gut. 1990 Feb;31(2):129–133. doi: 10.1136/gut.31.2.129. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Dudley N. E., Phelan P. D. Respiratory complications in long-term survivors of oesophageal atresia. Arch Dis Child. 1976 Apr;51(4):279–282. doi: 10.1136/adc.51.4.279. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Evans D. F., Haynes J., Jones J. A., Stower M. J., Kapila L. Ambulatory esophageal pH monitoring in children as an indicator for surgery. J Pediatr Surg. 1986 Mar;21(3):221–223. doi: 10.1016/s0022-3468(86)80838-7. [DOI] [PubMed] [Google Scholar]
- Halpern L. M., Jolley S. G., Tunell W. P., Johnson D. G., Sterling C. E. The mean duration of gastroesophageal reflux during sleep as an indicator of respiratory symptoms from gastroesophageal reflux in children. J Pediatr Surg. 1991 Jun;26(6):686–690. doi: 10.1016/0022-3468(91)90011-h. [DOI] [PubMed] [Google Scholar]
- Jolley S. G., Herbst J. J., Johnson D. G., Matlak M. E., Book L. S. Esophageal pH monitoring during sleep identifies children with respiratory symptoms from gastroesophageal reflux. Gastroenterology. 1981 Jun;80(6):1501–1506. [PubMed] [Google Scholar]
- Jolley S. G., Johnson D. G., Herbst J. J., Matlak M. E. The significance of gastroesophageal reflux patterns in children. J Pediatr Surg. 1981 Dec;16(6):859–865. doi: 10.1016/s0022-3468(81)80835-4. [DOI] [PubMed] [Google Scholar]
- Jolley S. G., Johnson D. G., Herbst J. J., Pena A., Garnier R. An assessment of gastroesophageal reflux in children by extended pH monitoring of the distal esophagus. Surgery. 1978 Jul;84(1):16–24. [PubMed] [Google Scholar]
- Jolley S. G., Johnson D. G., Roberts C. C., Herbst J. J., Matlak M. E., McCombs A., Christian P. Patterns of gastroesophageal reflux in children following repair of esophageal atresia and distal tracheoesophageal fistula. J Pediatr Surg. 1980 Dec;15(6):857–862. doi: 10.1016/s0022-3468(80)80293-4. [DOI] [PubMed] [Google Scholar]
- MILLER F. A., DOVALE J., GUNTHER T. UTILIZATION OF INLYING PH PROBE FOR EVALUATION OF ACID-PEPTIC DIATHESIS. Arch Surg. 1964 Jul;89:199–203. doi: 10.1001/archsurg.1964.01320010201021. [DOI] [PubMed] [Google Scholar]
- Orenstein S. R., Orenstein D. M. Gastroesophageal reflux and respiratory disease in children. J Pediatr. 1988 Jun;112(6):847–858. doi: 10.1016/s0022-3476(88)80204-x. [DOI] [PubMed] [Google Scholar]
- Ramenofsky M. L., Powell R. W., Curreri P. W. Gastroesophageal reflux. pH probe-directed therapy. Ann Surg. 1986 May;203(5):531–536. doi: 10.1097/00000658-198605000-00013. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Robertson D., Aldersley M., Shepherd H., Smith C. L. Patterns of acid reflux in complicated oesophagitis. Gut. 1987 Nov;28(11):1484–1488. doi: 10.1136/gut.28.11.1484. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Shepard R., Fenn S., Sieber W. K. Evaluation of esophageal function in postoperative esophageal atresia and tracheoesophageal fistula. Surgery. 1966 Apr;59(4):608–617. [PubMed] [Google Scholar]
- Sondheimer J. M., Morris B. A. Gastroesophageal reflux among severely retarded children. J Pediatr. 1979 May;94(5):710–714. doi: 10.1016/s0022-3476(79)80135-3. [DOI] [PubMed] [Google Scholar]
- Sondheimer J. M., Morris B. A. Gastroesophageal reflux among severely retarded children. J Pediatr. 1979 May;94(5):710–714. doi: 10.1016/s0022-3476(79)80135-3. [DOI] [PubMed] [Google Scholar]
- Werlin S. L., Dodds W. J., Hogan W. J., Arndorfer R. C. Mechanisms of gastroesophageal reflux in children. J Pediatr. 1980 Aug;97(2):244–249. doi: 10.1016/s0022-3476(80)80482-3. [DOI] [PubMed] [Google Scholar]
- Wesley J. R., Coran A. G., Sarahan T. M., Klein M. D., White S. J. The need for evaluation of gastroesophageal reflux in brain-damaged children referred for feeding gastrostomy. J Pediatr Surg. 1981 Dec;16(6):866–871. doi: 10.1016/s0022-3468(81)80836-6. [DOI] [PubMed] [Google Scholar]
- de Caestecker J. S., Blackwell J. N., Pryde A., Heading R. C. Daytime gastro-oesophageal reflux is important in oesophagitis. Gut. 1987 May;28(5):519–526. doi: 10.1136/gut.28.5.519. [DOI] [PMC free article] [PubMed] [Google Scholar]
