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KMID : 0816119990020020139
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Korean Journal of Pediatric Gastroenterolology and Nutrition
1999 Volume.2 No. 2 p.139 ~ p.146
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The Significance of 24-Hour Esophageal pH Monitoring in Children with Recurrent Vomiting or Regurgitation
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Lee So-Hyun
Chung Ki-Sup
Lee Chang-Han
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Abstract
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Purpose : The aim of this study was to evaluate the clinical significance of 24 hour
pH monitoring in the pediatric patients with recurrent vomiting or regurgitation.
Methods : We performed 24 hour pH monitoring on 87 pediatric patients with
recurrent vomiting or regurgitation using GastrograpH with glass electrode. The
pathologic GER was determined by the reflux index (RI). RIs > 10% were considered
positive in patients < 1 year of age, whereas RIs of > 5% were positive in other age
groups. We evaluated the mean and standard deviation of the reflux parameters between
physiologic and pathologic GER groups, and also compared the reflux indices of each
group with respect to time zones of the day.
Results : Pathologic GER was found in 32 of 87 patients (36.8%), and the age
incidence included 32.5% in infants < 6 months old, 13.3% in infants aged 6 months-1
year old, 61.5% in children aged 1∼2 years old, 14.3% in children aged 2∼3 years old
and 66.7% in children >3 years old. In physiologic GER patients, the RI was 3.7±2.9%
for the patents < 1 year old (group A), and 1.8±1.5% for those ≥ 1 year old (group B)
which was statistically significant between the 2 age groups (p=0.02). The number of
long refluxes more than 5 minutes was significantly increased (p=0.03) in group A (1.7
±1.9) than in group B (0.8±1.0). The duration of the longest reflux was significantly
longer (p=0.007) in group A (604±551 sec) than in group B (271±296 sec). In
pathologic GER patients, the RI was 17.7±11.6% for the patients < 1 year old and 7.8±
2.9 for those ≥ 1 year old. The number of long refluxes of more than 5 minutes were
8.9±4.6 and 3.2±1.8, and the duration of the longest reflux were 1955±2190 sec and
1093±706 sec for each age group. In both physiologic and pathologic GER patients,
there was no significant difference of RI among the time zones of the day.
Conclusion : Pathologic GER was found in 36.8% of patients. There was significant
difference of RI between those < 1 year old and those ≥ 1 year old in physiologic GER
patients. There was no significant difference of RI among the time zones of the day in
both pathologic and physiologic groups. In our study, the frequency of pathologic GER
was too much higher in age group of 1∼2 years old (61.5%) than in group of 6
months-1 year old (13.3%), which means that further study is needed to determine the
pathologic criteria of RI (Vandenplas criteria is >5%) in the age group of 1∼2 years
old.
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KEYWORD
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Gastroesophageal reflux, Esophageal pH monitoring, Vomiting, Regurgitation,
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