Evaluating Clinical Features and Ph-Impedance data in Pediatric Patients With Gastroesophageal Reflux DISEASE

Aims We aim to establish clinical features and pH-impedance data associated with reflux esophagitis (RE) and nonerosive reflux disease (NERD).

Methods We analyzed data of 86 patients age 1-17, who underwent 24-hour impedance-pH study and upper gastrointestinal endoscopy at RSPC for Pediatric Surgery between January 2018 to August 2020. Male - 56 (65 %), female - 30 (35 %).

Criteria for inclusion of patients in the study: abnormal esophageal reflux burden on the pH-impedance monitoring, endoscopy changes in the form of esophagitis, and gastroesophageal reflux disease (GERD) related symptoms. RE was diagnosed based on the Los Angeles classification system. Diagnosis of GERD was established based on the result of the MII/pH study and according to the recommendation of guidelines on pediatric GERD clinical practice (acid exposure time (AET) > 7 %, a total number of retrograde bolus movements (RBM) > 70). Patients were excluded based on the history of any abdominal surgery. Patients were divided into those with RE (n = 34): male/female 24 (71 %)/10 (29 %); and NERD (n = 52): male/female 32 (62 %)/20 (38 %). They were reported typical esophageal symptoms (heartburn, vomiting, belching, abdominal pain), atypical extra-esophageal symptoms (cough, burp, sour taste, recurrent bronchitis), and those with combined symptoms (both typical and atypical).

Results 86 pediatric patients fulfilled the inclusion criteria.

Tab.1

Characteristic	RE, n = 34 AM (95 %CI)	NERD, n = 52 AM (95 %CI)	Mann-Whitney test P-value
AET(%)	10.04 (7.81 to 12.28)	11.15 (8.92 to 13.38)	0.608
Number of RBM	78.91 (63.98 to 93.84)	69.46 (56.7 to 82.22)	0.342
Proximal events	30.76 (21.7 to 39.8)	26.39 (20.49 to 32.28)	0.672
Distal mean nocturnal baseline impedance (MNBI), in kOhm	1.90 (1.67 to 2.13)	2.21 (2.02 to 2.3)	0.0208

Table: pH-impedance data of RE patients. Data are presented as arithmetic mean (AM); CI: Confidence interval.

Results of clinical symptoms: in the group RE with typical symptoms: patients 14 (41 %), with atypical symptoms: 12 (35 %), with combined symptoms: 8 (24 %). In the group NERD with typical symptoms: patients 11 (21 %), with atypical symptoms: 16 (31 %), with combined symptoms: 25 (48 %).

Conclusions We found a significant difference only in one pH-impedance parameter - distal MNBI (p = 0.0208). Typical symptoms prevail in the group of patients with RE (41 %). Males mostly suffer from GERD in study groups: RE (71 %), NERD (62 %).

Citation: Aksionchyk M. eP39 EVALUATING CLINICAL FEATURES AND PH-IMPEDANCE DATA IN PEDIATRIC PATIENTS WITH GASTROESOPHAGEAL REFLUX DISEASE. Endoscopy 2021; 53: S109.

Publication History

Article published online:
19 March 2021