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The interpretation of oesophageal pH monitoring data

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Abstract

Continuous monitoring of oesophageal pH is regarded as the gold standard for all reflux investigations. However, since gastro-oesophageal reflux is considered a normal phenomenon which occurs to a certain extent in each individual, the distinction between “normal” and “abnormal” is not always obvious and is not possible to achieve with a single test. Moreover, data depend on technical hardware such as recording devices and electrodes together with such patient characteristics as age, position, activity, and medication. Although much literature on pH monitoring has appeared recently, many investigations have failed to take into account the basic principles that are of major importance for any biomedical test such as reproducibility, sample reliability, and indications. There is a need to standardize the technique in order to compare studies performed in different centres, provided the technique is reproducible.

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Abbreviations

GOR:

gastro-oesophageal reflux

References

  1. Anonymous (1982) Gastro-oesophageal reflux in children. Lancet I:144–145

    Google Scholar 

  2. Belli DC, Le Coultre C (1989) Comparison in a same patient of short, middle and long term pH metry recordings in the presence or absence of a gastroesophageal reflux in children. Pediatr Res 26:268

    Google Scholar 

  3. Bennett JR (1976) Medical management of gastro-oesophageal reflux. Clin Gastroenterol 5:175–185

    Google Scholar 

  4. Bennett JR (1987) pH Measurement in the oesophagus. Ballières Clin Gastroenterol 2:747–767

    Google Scholar 

  5. Boesby S (1975) Gastro-oesophageal acid reflux and sphincter pressure in normal human subjects. Scand J Gastroenterol 10:731–736

    PubMed  Google Scholar 

  6. Boesby S (1977) Relationship between gastro-oesophageal acid reflux, basal gastro-oesophageal sphincter pressure and gastric acid secretion. Scand J Gastroenterol 12:547–555

    PubMed  Google Scholar 

  7. Branicki FJ, Evans DF, Ogilvie AF, Atkinson M, Hardcastle JD (1982) Ambulatory monitoring of oesophageal pH in reflux oesophagitis using a portable radiotelemetry system. Gut 23:992–998

    PubMed  Google Scholar 

  8. Casten DF, Bernhang A, Nack RJ (1963) A physiological basis for the surgical treatment of sliding hiatal hernia. Surg Gynecol Obstet 117:87–93

    PubMed  Google Scholar 

  9. De Caestecker JS (1989) Twenty-four-hour oesophageal pH monitoring: advances and controversaries. NJ Med [Suppl] 34:20–39

    Google Scholar 

  10. De Caestecker JS, Blackwell JN, Pryde A, Heady RC (1987) Daytime gastro-oesophageal reflux is important in oesophagitis. Gut 28:519–526

    PubMed  Google Scholar 

  11. DeMeester TR, Johnson LF (1976) The evaluation of objective measurements of gastroesophageal reflux and their contribution to patient management. Surg Clin North Am 56:39–53

    PubMed  Google Scholar 

  12. DeMeester TR, Johnson LF, Joseph GJ, Toscano MS, Hala AW, Skinner DB (1976) Patterns of gastro-esophageal reflux in health and disease. Ann Surg 184:456–470

    Google Scholar 

  13. Dent J (1988) Gastro-oesophageal reflux and pH monitoring. Curr Opinion Gastro-Enterol 4:547–533

    Google Scholar 

  14. Dodds WJ, Hogan WJ, Hjelm JF, Dent J (1981) Pathogenesis of reflux esophagitis. Gastroenterology 81:376–394

    PubMed  Google Scholar 

  15. Hollander F (1944) What is pH? Explanation of various measures of acidity employed in gastroesophageal reflux. Gastroenterology 4:497–508

    Google Scholar 

  16. Johnson LF, DeMeester TR (1974) Twenty-four hour pH monitoring in the distal esophagus. Am J Gastroenterol 62:325–332

    PubMed  Google Scholar 

  17. Johnson LF, DeMeester TR (1974) Advantage of distal esophageal 24 hour pH monitoring over other tests for gastro-esophageal reflux. Gastroenterology 66:A63

    Google Scholar 

  18. Johnson LF, DeMeester TR (1986) Development of the 24 hour intraesophageal pH monitoring composition scoring system. J Clin Gastroenterol 8 [Suppl 1]:52–58

    PubMed  Google Scholar 

  19. Johnsson F, Joelsson B, Isberg PE (1987) Ambulatory 24 hour intraesophageal pH monitoring in the diagnosis of gastroesophageal reflux disease. Gut 28:1145–1150

    PubMed  Google Scholar 

  20. Jolley SG, Johnsson DG, Herbst JJ, Pena A, Garnier R (1978) An assessment of gastroesophageal reflux in children by extended pH monitoring of the distal esophagus. Surgery 84:16–24

    PubMed  Google Scholar 

  21. Jolley SG, Herbst JJ, Johnson DG (1979) Patterns of postcibal gastroesophageal reflux in symptomatic infants. Am J Surg 138:946–951

    PubMed  Google Scholar 

  22. Kaye MD (1977) Postprandial gastro-oesophageal reflux in healthy people. Gut 18:709–712

    PubMed  Google Scholar 

  23. Malfroot A, Vandenplas Y, Verlinden M, Piepsz A, Dab I (1987) Gastroesophageal reflux and unexplained chronic respiratory disease in infants and children. Pediatr Pulmonol 3:208–214

    PubMed  Google Scholar 

  24. McLaughlan, Rawlings JM, Lucas ML, McCloy RF, Crean GR, McColl KEL (1987) Electrodes for 24 hour pH monitoring—a comparative study. Gut 28:935–939

    PubMed  Google Scholar 

  25. Nevane S, Panayotou J, Milla PJ (1989) 6 Hours post-prandial pH monitoring: an adequate test for gastro-oesophageal reflux in children and infants. Pediatr Res: 275

  26. Ottignon Y, Ampelas M, Voigt JJ, Cassigneul J, Pascal JP (1981) Comparaison de trois méthodes d'enregistrement de pH oesophagien dans le diagnostic du reflux gastro-oesophagien acide. Gastroenterol Clin Biol 8:609–615

    Google Scholar 

  27. Piepsz A, Ham HR (1989) Nuclear medicine in the evaluation of gastrointestinal structure and function in children. Front Gastrointest Res 15:213–232

    Google Scholar 

  28. Reyes HM, Ostrovsky E, Radhakrishnan J (1982) Diagnostic accuracy of a 3-hour continuous intraluminal pH monitoring of the lower esophagus in the evaluation of gastro-esophageal reflux in infancy. J Pediatr Surg 17:626–631

    Google Scholar 

  29. Robertson D, Aldersley H, Shepherd H, Smith Cl (1987) Patterns of acid reflux in complicated oesophagitis. Gut 28:1484–1488

    PubMed  Google Scholar 

  30. Sacré L, Vandenplas Y (1989) Gastroesophageal reflux associated with respiratory abnormalities during sleep. J Pediatr Gastroenterol Nutr 9:28–33

    PubMed  Google Scholar 

  31. Schindbleck NE, Heinrich C, König A, Dendorfer A, Pace F, Müller-Lissner SA (1987) Optimal thresholds, sensitivity and specificity of long-term pH-metry for the detection of gastroesophageal reflux disease. Gastroenterology 93:85–90

    PubMed  Google Scholar 

  32. Schlesinger PK, Donahue PE, Schmid B, Layden TJ (1985) Limitations of 24-hour intraesophageal ph monitoring in the hospital setting. Gastroenterology 89:797–804

    PubMed  Google Scholar 

  33. Sondheimer JM (1980) Continuous monitoring of distal esophageal pH: a diagnostic test for gastro-esophageal reflux in infants. J Pediatr 96:804–807

    PubMed  Google Scholar 

  34. Sondheimer JM (1988) Gastroesophageal reflux: update on pathogenesis and diagnosis. Pediatr Clin North Am 35:103–116

    PubMed  Google Scholar 

  35. Sondheimer JM, Haase GA (1988) Simultaneous pH recordings from multiple sites in children with and without distal gastroesophageal reflux. J Pediatr Gastroenterol Nutr 7:46–51

    PubMed  Google Scholar 

  36. Squire BH, Glick S, Benn A (1968) Maximal acid output and oesophagitis in hiatal hernia. Thorax 23:685–689

    Google Scholar 

  37. Stanciu C (1975) Gastric secretion, gastroesophageal reflux and esophagitis. Am J Gastroenterol 69:104–107

    Google Scholar 

  38. Stanciu C, Bennett JR (1977) Effects of posture on gastro-oesophageal reflux. Digestion 15:104–109

    PubMed  Google Scholar 

  39. Sutphen JL, Dillard VL (1988) Effect of feeding volume on early postcibal gastro-esophageal reflux in infants. J Pediatr Gastroenterol Nutr 7:185–188

    PubMed  Google Scholar 

  40. Tuttle SG, Ruffin F (1961) The physiology of heartburn. Ann Intern Med 55:292–300

    PubMed  Google Scholar 

  41. Vandenplas Y (1990) Dependability of oesophageal pH monitoring data on cut-off limits: the oscillatory index. Acta Gastroenterol Belg (in press)

  42. Vandenplas Y, Sacré L (1985) Seventeen hour continuous esophageal pH monitoring in the newborn: evaluation of the influence of the position in asymptomatic and symptomatic babies. J Pediatr Gastroenterol 4:356–361

    PubMed  Google Scholar 

  43. Vandenplas Y, Sacré L (1987) Continuous 24-hour esophageal pH monitoring in 285 asymptomatic infants 0–15 months old. J Pediatr Gastroenterol Nutr 6:220–224

    PubMed  Google Scholar 

  44. Vandenplas Y, Sacré L (1987) Milk-thickening agents as a treatment for gastroesophageal reflux. Clin Pediatr 26:66–68

    Google Scholar 

  45. Vandenplas Y, Sacré-Smits L (1987) Gastro-oesophageal reflux in infants. Evaluation of treatment by pH monitoring. Eur J Pediatr 146:504–507

    PubMed  Google Scholar 

  46. Vandenplas Y, DeWolf D, Sacré L (1986) Influence of xanthines on gastroesophageal reflux in infants at risk for sudden infant Death Syndrome. Pediatrics 77:807–810

    PubMed  Google Scholar 

  47. Vandenplas Y, DeWolf D, Deneyer M, Sacré L (1988) Incidence on gastroesophageal reflux in sleep, awake, fasted and postcibal periods in asymptomatic and symptomatic infants. J Pediatr Gastroenterol Nutr 7:177–180

    PubMed  Google Scholar 

  48. Vandenplas Y, Franckx-Goossens A, Pipeleers-Marichal M, Derde MP, Sacré-Smits L (1989) Area under pH 4: advantages of a new parameter in the interpretation of esophageal pH monitoring data in infants. J Pediatr Gastroenterol Nutr 9:34–39

    PubMed  Google Scholar 

  49. Vandenplas Y, Goyvaerts H, Helven R, Sacré L (1990) Do oesophageal pH monitoring data depend on recording equipment and probes? J Pediatr Gastroenterol Nutr 10:322–326

    PubMed  Google Scholar 

  50. William B, Lucka M, Ellington JH, Dain A, Wicks ACB (1988) Young patients with symptomatic dyspepsia are overinvestigated. Lancet I:1349–1351

    Google Scholar 

  51. Williams CB, Laurie JH, Forrest APM (1967) Acid secretion in symptomatic sliding hiatal hernia. Lancet I:184–185

    Google Scholar 

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  1. Academisch Ziekenhuis Kinderen Vrije Universiteit Brussel, Laarbeeklaan 101, B-1090, Brussels, Belgium

    Y. Vandenplas & H. Loeb

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  1. Y. Vandenplas
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  2. H. Loeb
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Vandenplas, Y., Loeb, H. The interpretation of oesophageal pH monitoring data. Eur J Pediatr 149, 598–602 (1990). https://doi.org/10.1007/BF02034740

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  • DOI: https://doi.org/10.1007/BF02034740

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