TITLE

ASSESSMENT OF REFLUX IN NEUROLOGICALLY-IMPAIRED CHILDREN USING THE MULTIPLE INTRALUMINAL IMPEDANCE PROCEDURE

AUTHOR(S)
Thomson, M.; Rawat, D.; Ball, G.; Wenzl, T.; Del Buono, R.
PUB. DATE
April 2003
SOURCE
Gut;Apr2003 Supplement 1, Vol. 52, pA86
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Background: In addition to acid gastro-oesophageal reflux (GOR), non-acid GOR (pH > 4) may be clinically relevant in neurologically impaired children. However, standard pH metry can only detect the former. We have therefore used the pH independant technique of intraluminal electrical impedance to quantify all reflux events. Aim: The aim of this study was to quantify acid and non-acid reflux in a group of these patients using a new catheter related technique. Methods: Ten children (9 cerebral palsy, 1 Trisomy 27) fed intragastrically underwent 12 h studies of intra-oesophageal 6 channel impedance and dual channel pH monitoring. All patients were off medication influencing gastric pH. Recordings were analysed for the frequency of acid and non-acid GOR and the height reached by the refluxate. Results: 369 reflux events were detected with the combined technique. 191 (51.8%) were non-acid events (mean pH 5.6) and of these 138 (72.2%) reached the uppermost (1) impedance channel. Of the 178 acid reflux events (mean pH 3.1), 81.5% reached the uppermost channel. Conclusions: Over half of reflux events in neurologically impaired children are non-acidic and therefore are missed using standard pH merry. Most of these refluxes reached the upper oesophagus. Simultaneous intraoesophageal impedance and pH measurements proves to add valuable information that may improve therapeutic management in this patient group.
ACCESSION #
9747855

 

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