دور المراقبة المتواقتة للمعاوقة المريئية و الحموضة pH مدة 24 ساعة في تشخيص داء الجزر المعدي المريئي عند الرضع و الأطفال دون السنتين من العمر

Abstract EN

Background& Objective: Recent studies has proved that high proportion of reflux episodes in Gastro Esophageal Reflux Disease(GERD) were non acidic ,and could not be detected by classic pH metry alone, especially less than 2 years, in whom nutrition is mainly depending on milk .It was too necessarily to improve a new technique (Multichannel Intraluminal Impedance MII) ,and by this any retrograde flow to the esophagus can be detected .

The aim of this study was to determine whether pH-monitoring alone is sufficient to diagnose the Gastro Esophageal Reflux Disease (GERD),and how much the diagnosis was improved after Multichannel Intraluminal Impedance (MII) has been added to the standard pH catheter in children less than 2 years.

Materials & Methods: This was an observational cross-sectional study on 15 children(males and females), admitted at Damascus university children Hospital between 1.10.2010 and 1.4.2011 , (mean age 8.5±6.3 mo) ,their symptoms were suggestive of GERD (vomiting, dysphagia, recurrent cough or choking, wheezy chest ,uncontrolled asthma, recurrent aspiration pneumonia, recurrent stridor or apnea ).

Cases of anatomical malformation and previews esophageal or gastric surgery have been excluded ,MII and pH monitoring for 24 hours has been done to the all patients after discontinuing of anti reflux medication or procedures, then data has taken from pH sensor alone first and from MII-pH sensors second.

Results: total of 1953 reflux episodes were detected by MII-PH monitoring, %46 of them were non acidic ,these results based on pH monitoring alone has diagnosed GERD in 47%only ,while the total cases of GERD were 87% of all children(results based on MII-pH monitoring).

Most cases of positive MII monitoring were less than 1 year.

Conclusion :MII-pH monitoring is an important technique in detecting reflux episodes less than 2 years especially in infants, in whom most reflux episodes are non acidic, hence we have not to relay on pH monitoring alone in diagnosis of GERD in infants.