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Combined Multichannel Intraluminal Impedance-pH (MII-pH): Multicenter Report of Normal Values from 117 Children

  • Pediatric Gastroenterology (S Orenstein, Section Editor)
  • Published:
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Abstract

Although combined multichannel intraluminal impedance/esophageal pH monitoring (MII-pH) has replaced prolonged pH monitoring alone for assessing gastroesophageal reflux (GER) in the pediatric population, it does so in the absence of reference values for non-acid GER (NAGER). The purpose of this study was to identify a normal range of NAGER impedance values for infants and children. We evaluated EPM/MII tracings for patients referred for GER assessment to Nationwide Children’s Hospital (Columbus, OH), Inova Children’s Hospital, and Hospital Italiano (Buenos Aires, Argentina). We excluded tracings from patients who had AGER indices greater than 50 % of the upper end of normal (i.e., >3 % for children >12 months and >6 % for infants ≤12 months), had a positive temporal association of GER with symptoms, were on anti-reflux medications at the time of the study, and/or had a fundoplication prior to the study. We also excluded studies with durations shorter than 20 h. Values for NAGER percent time, NAGER episode frequency, frequency of proximal NAGER, and mean NAGER duration were calculated for upright position, recumbent, and total. Study population consisted of 46 infants (20 female [F]/26 male [M], median age 4.8 months [range 3 weeks–11.9 months]) with a median AGER index of 2.2 % (range 0.0–5.9 %) and 71 children (22 F/49 M, median age 7.2 years [range 1.3–17 years]) with a median AGER index of 1.1 % (range 0–3.0 %). Data are presented in tables in the text. The results of this study provide a range of values characteristic of infants and children with normal AGER indices and no positive temporal associations of GER with symptoms. These values may be used as references for comparison to identify infants and/or children who may be at risk of developing serious clinical manifestations due to abnormal patterns of GER.

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Conflict of Interest

Study was supported by an educational grant from MMS. Hayat Mousa, Rodrigo Machado, Marina Orsi, Catherine S. Chao, Tala Alhajj, Mark Alhajj, Courtney Port, Beth Skaggs, and Frederick W. Woodley declare no conflict of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with animal subjects performed by any of the authors. With regard to the authors’ research cited in this paper, all procedures were followed in accordance with the ethical standards of the responsible committee on human experimentation and with the Helsinki Declaration of 1975, as revised in 2000 and 2008.

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Authors and Affiliations

  1. Division of Pediatric Gastroenterology, Nationwide Children’s Hospital, 700 Children’s Drive, JW 1985, Columbus, OH, USA

    Hayat Mousa, Rodrigo Machado, Tala Alhajj, Mark Alhajj, Beth Skaggs & Frederick W. Woodley

  2. The Department of Pediatrics, The Ohio State University, Nationwide Children Hospital, Columbus, OH, USA

    Hayat Mousa & Frederick W. Woodley

  3. Inova Children’s Hospital, Falls Church, VA, USA

    Catherine S. Chao & Courtney Port

  4. The Pediatric Gastroenterology, Hepatology and Transplant Unit, Hospital Italiano, Buenos Aires, Argentina

    Marina Orsi

Authors
  1. Hayat Mousa
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  2. Rodrigo Machado
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  3. Marina Orsi
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  4. Catherine S. Chao
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  5. Tala Alhajj
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  6. Mark Alhajj
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  7. Courtney Port
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  8. Beth Skaggs
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  9. Frederick W. Woodley
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Corresponding author

Correspondence to Hayat Mousa.

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This article is part of the Topical Collection on Pediatric Gastroenterology

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Mousa, H., Machado, R., Orsi, M. et al. Combined Multichannel Intraluminal Impedance-pH (MII-pH): Multicenter Report of Normal Values from 117 Children. Curr Gastroenterol Rep 16, 400 (2014). https://doi.org/10.1007/s11894-014-0400-6

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  • DOI: https://doi.org/10.1007/s11894-014-0400-6

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