Non acid gastroesophageal reflux episodes decrease with age as determined by multichannel intraluminal impedance-ph monitoring in symptomatic children

Abstract

Objectives: To determine whether changes related to age in gastroesophageal reflux (GER) in infants and children are due to acid, non acid reflux or both, as determined by 24 hr pH probe (pH) and Multichannel Intraluminal Impedance (MII). Methods: Tracings of simultaneous pH-MII from 243 infants and children who presented with either digestive or respiratory symptoms attributable to GER were reviewed and analyzed using Mann-Whitney U test. Results: The number of GER episodes recorded was similar among children with predominantly gastrointestinal and those with respiratory symptoms. A significantly higher total number of GER episodes was observed by pH probe and MII in children under 22.8 mos of age compared with those who were older (median 159 vs. 110.5, p = 0.002). There was no significant change with age of acid reflux (AR) parameters. The changes observed were due to the significant decrease of non AR for all parameters measured, regardless of the presenting symptom. Conclusions: The decrease in GER parameters that is observed after a mean of 22.8 mos. of age is at the expense of non AR. This finding may have an impact on the choice and results of therapeutic modalities in children versus that in infants.

Keywords

• gastroesophageal reflux
• multichannel intraluminal impedance
• non acid reflux
• pH probe