Published online January 2, 2007
PEDIATRICS Vol. 119 No. 1 January 2007, pp. 118-122 (doi:10.1542/peds.2006-1753)
This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow P3Rs: Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when P3Rs are posted
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow E-mail this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My File Cabinet
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via CrossRef
Right arrow Citing Articles via ISI Web of Science (3)
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Vandenplas, Y.
Right arrow Articles by Hauser, B.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Vandenplas, Y.
Right arrow Articles by Hauser, B.
Related Collections
Right arrow Gastrointestinal Tract

REVIEW ARTICLE

Will Esophageal Impedance Replace pH Monitoring?

Yvan Vandenplas, MD, PhDa, Silvia Salvatore, MDb, Mario C. Vieira, MDc and Bruno Hauser, MDa

a Department of Pediatrics, Academisch Ziekenhuis Vrije Universiteit Brussel, Brussels, Belgium
b Clinica Pediatrica di Varese, Università dell'Insubria, Varese, Italy
c Hospital Pequeno Príncipe, Curitiba, Brazil

Esophageal impedance, a technique based on the fact that the passage of a bolus changes the impedance between esophageal segments, is being used more and more. Multiple esophageal impedance combined with pH monitoring is advocated to become the preferred technique to measure acid and nonacid gastroesophageal reflux. Compared with pH monitoring, impedance has the advantage of being independent of pH and, as a consequence, is better adapted to measure reflux (especially in the postprandial period when reflux is buffered) and detect symptoms associated with nonacid- or weakly acid-reflux episodes. Conversely, the analysis of an impedance tracing requires more time and knowledge than a pH tracing and is possibly subjected to higher interobserver variability. Day-to-day reproducibility and interobserver variability are considerable. Episodes detected only by pH monitoring or impedance are numerous in pediatrics; therefore, pH monitoring and impedance should be associated in analyses of multiple esophageal impedance combined with pH monitoring. Up to now, there has been a striking absence of literature showing attempts to link data from diagnostic procedures to clinical outcome in symptomatic patients. Furthermore, data suggesting that impedance does offer a clear-cut benefit in pediatric clinical routine are missing. High cost of the material and the investment in time necessary for interpretation of the recording remain a handicap. However, because pH monitoring is part of impedance technology, it is likely that the latter will soon replace pH monitoring despite the current need of scientific evidence demonstrating a relation between symptoms, esophageal damage or response to reflux treatment, and results of multiple esophageal impedance combined with pH monitoring.

Key Words: impedance • pH monitoring • gastroesophageal reflux • child

Abbreviations: GER—gastroesophageal reflux • MII-pH—multiple esophageal impedance combined with pH monitoring

Accepted Sep 14, 2006.




This article has been cited by other articles:


Home page
 Pediatr. Rev.Home page
J. E. Dranove
Focus on Diagnosis: New Technologies for the Diagnosis of Gastroesophageal Reflux Disease
Pediatr. Rev., September 1, 2008; 29(9): 317 - 320.
[Full Text] [PDF]