Value of pH probe testing in pediatric patients with extraesophageal manifestations of gastroesophageal reflux disease: a retrospective review

N M Bauman; W P Bishop; A D Sandler; R J Smith

doi:10.1177/0003489400109s1005

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Journal article

Value of pH probe testing in pediatric patients with extraesophageal manifestations of gastroesophageal reflux disease: a retrospective review

N M Bauman, W P Bishop, A D Sandler and R J Smith

Annals of otology, rhinology & laryngology. Supplement, Vol.184, pp.18-24

10/2000

DOI: 10.1177/0003489400109s1005

PMID: 11051426

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Abstract

Extended pH probe testing is often performed in patients believed to have extraesophageal symptoms of gastroesophageal reflux disease (GERD), although for this indication its diagnostic value is not well established. A retrospective review of all patients who underwent pH probe testing between 1994 and 1998 was conducted to determine the outcome of antireflux therapy in the subgroup with probable extraesophageal symptoms of GERD. Sixty-eight patients underwent antireflux therapy and had adequate follow-up after pH probe testing to be included in the study. Fifty-eight patients (85%) responded to antireflux therapy (improved, 44%; cured, 41%). The positive predictive value of distal pH probe testing was greater than 90%, but the negative predictive value was less than 50%. The reproducibility of pH probe testing on different study days was poor, but pH probe testing was helpful in assessing the adequacy of antireflux therapy. The presence of gastrointestinal symptoms did not correlate with the response of extraesophageal symptoms to antireflux therapy. Thirteen patients underwent double-probe pH studies. The mean percent time the pH was less than 4 in the upper esophagus was 2.6% (range, 1% to 9.6%). Twelve of these patients were improved or cured with antireflux therapy. Distal pH probe testing is of limited benefit in predicting whether patients with extraesophageal symptoms of GERD will respond to antireflux therapy. If extraesophageal symptoms of GERD are suspected, patients should undergo an empiric trial of antireflux therapy. Distal pH probe testing should be reserved for assessing the adequacy of antireflux therapy if symptoms persist. A prospective, randomized, controlled study will aid in determining the predictive value of double-probe pH studies in pediatric patients with probable extraesophageal symptoms of GERD.

Anti-Ulcer Agents - therapeutic use

Diagnosis, Differential

Monitoring, Ambulatory - instrumentation

Gastroesophageal Reflux - diagnosis

Proton Pump Inhibitors

Gastric Acidity Determination - instrumentation

Humans

Otorhinolaryngologic Diseases - drug therapy

Child, Preschool

Infant

Male

Treatment Outcome

Gastroesophageal Reflux - complications

Adolescent

Gastrointestinal Agents - therapeutic use

Female

Gastroesophageal Reflux - drug therapy

Otorhinolaryngologic Diseases - etiology

Child

Otorhinolaryngologic Diseases - diagnosis

Infant, Newborn

Details

Title: Subtitle: Value of pH probe testing in pediatric patients with extraesophageal manifestations of gastroesophageal reflux disease: a retrospective review
Creators: N M Bauman - Department of Otolaryngology-Head and Neck Surgery, University of Iowa College of Medicine, Iowa City, USA
W P Bishop
A D Sandler
R J Smith
Resource Type: Journal article
Publication Details: Annals of otology, rhinology & laryngology. Supplement, Vol.184, pp.18-24
DOI: 10.1177/0003489400109s1005
PMID: 11051426
NLM abbreviation: Ann Otol Rhinol Laryngol Suppl
ISSN: 0096-8056
Publisher: United States
Language: English
Date published: 10/2000
Academic Unit: Roy J. Carver Department of Biomedical Engineering; Molecular Physiology and Biophysics; Anatomy and Cell Biology; Stead Family Department of Pediatrics; Iowa Neuroscience Institute; Otolaryngology; Internal Medicine
Record Identifier: 9984007188802771

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