Diagnostic modalities for gastroesophageal reflux

Indian Journal of Pediatrics
A K PatwariGaurav Kapoor

Abstract

To evaluate commonly utilized diagnostic modalities to detecting Gastroesophageal Reflux (GER). Sixty children aged 1-72 months (mean age 14.7 months) with symptoms suggestive of Gastroesosphageal Reflux (GER) were investigated and subjected to upper gastrointestinal endoscopy and esophageal biopsy (EB), gastroesophageal scintiscanning (GS) and 24 hour ambulatory pH monitoring. GER was detected in 28 (46.7%) cases by one or more diagnostic modalities. Ambulatory 24 hour pH monitoring was positive in higher proportion (43.3%) of cases in comparison to other modalities, followed by EB (38.3%) and GS (30%). Considering 24 hour pH monitoring as the gold standard, esophageal biopsy was positive in 22/26 cases (84.6%) detected by 24 hour pH monitoring with a specificity of 97.1% as compared to 17/26 cases (65.4%) by gastroesophageal scintiscanning with a specificity of 97.1%. When compared with EB results, amongst various parameters measured during 24 hour pH monitoring, Reflux index (RI) ranked highest (sensitivity 95.6 % and specificity 89.2 %) followed by duration of longest episode > 20 minutes and Euler Byrne score. Oscillatory index, calculated from tracings of pH monitoring, even though ranked lower because of its low sensitiv...Continue Reading

References

Oct 1, 1990·Journal of Pediatric Gastroenterology and Nutrition·Y VandenplasR Helven
Oct 1, 1985·Journal of Pediatric Gastroenterology and Nutrition·L J NewmanS M Schwarz
Jan 1, 1981·Pediatric Radiology·A PiepszS Cadranel
Jul 1, 1997·Journal of Pediatric Gastroenterology and Nutrition·D SimeoneA Staiano
Jan 16, 1999·Gastroenterology Clinics of North America·M A Young, J C Reynolds

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