Published online January 2, 2007
PEDIATRICS Vol. 119 No. 1 January 2007, pp. 118-122 (doi:10.1542/peds.2006-1753)

This Article Full Text Full Text (PDF) Submit a response Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services E-mail this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to My File Cabinet Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via CrossRef Citing Articles via Web of Science (3) Citing Articles via Google Scholar Google Scholar Articles by Vandenplas, Y. Articles by Hauser, B. Search for Related Content PubMed PubMed Citation Articles by Vandenplas, Y. Articles by Hauser, B. Related Collections Gastrointestinal Tract Social Bookmarking                         What's this?

REVIEW ARTICLE

Will Esophageal Impedance Replace pH Monitoring?

Yvan Vandenplas, MD, PhD^a, Silvia Salvatore, MD^b, Mario C. Vieira, MD^c and Bruno Hauser, MD^a

^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.

CiteULike    Connotea    Del.icio.us    Digg    Facebook    Reddit    Technorati    Twitter    What's this?

This article has been cited by other articles:

				M P Tighe, M Cullen, and R M Beattie How to use: a pH study Arch. Dis. Child. Ed. Pract., February 1, 2009; 94(1): 18 - 23. [Full Text] [PDF]

				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]