Document Detail


Diagnostic modalities for gastroesophageal reflux.
MedLine Citation:
PMID:  11929028     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To evaluate commonly utilized diagnostic modalities to detecting Gastroesophageal Reflux (GER). METHODS: 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. RESULT: 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 sensitivity helped to pick up 2 cases missed by EB and RI. CONCLUSION: Our results suggest that a combination of diagnostic modalities may be required to diagnose GER in young children. Ambulatory 24 hour pH monitoring appears to be the single best investigation and combining it with EB and/or GS can help to detect maximum number of cases.
Authors:
A K Patwari; Pramila Bajaj; Ravi Kashyp; V K Anand; Ashutosh Gangil; Amit Jain; Gaurav Kapoor
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Indian journal of pediatrics     Volume:  69     ISSN:  0019-5456     ISO Abbreviation:  Indian J Pediatr     Publication Date:  2002 Feb 
Date Detail:
Created Date:  2002-04-03     Completed Date:  2002-04-23     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0417442     Medline TA:  Indian J Pediatr     Country:  India    
Other Details:
Languages:  eng     Pagination:  133-6     Citation Subset:  IM    
Affiliation:
Department of Pediatrics LHMC and Associated Kalawati Saran Children's Hospital, New Delhi, India. akpatwari@hotmail.com
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MeSH Terms
Descriptor/Qualifier:
Biopsy, Needle
Child
Child, Preschool
Diagnostic Techniques, Digestive System*
Esophagoscopy / methods
Female
Gastroesophageal Reflux / diagnosis*
Humans
Hydrogen-Ion Concentration
Infant
Male
Monitoring, Physiologic / methods
Predictive Value of Tests
Prospective Studies
Radionuclide Imaging / methods
Sensitivity and Specificity
Severity of Illness Index

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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