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Predictive value of esophageal manometry and gastroesophageal pH monitoring for responsiveness of reflux disease to medical therapy in children.
Am J Gastroenterol 1996; 91(4):680-5AJ

Abstract

OBJECTIVES

The aim of the study was to evaluate, in 42 children with gastroesophageal reflux disease, the predictive value of both esophageal manometry and gastroesophageal intraluminal pH on the responsiveness of the disease to medical therapy.

METHODS

Motility of lower esophageal sphincter and esophageal body was carried out through a perfused pediatric sleeve-probe; prolonged recording of the sphincteric profile was evaluated at the occurrence of reflux episodes as detected by an esophageal electrode; intraluminal pH of the esophagus and stomach was also measured for 24-h through portable equipment. Children were treated for 8 wk with cisapride and ranitidine and were classified as healed or refractory after endoscopy and clinical evaluation.

RESULTS

Twenty one children healed, and 21 were refractory. Compared with healed patients, refractory patients showed, at basal evaluation, an increased esophageal acid exposure (p < 0.05), a reduced basal sphincteric pressure and peristalsis amplitude (p < 0.01), an increased rate of sphincteric pressure drifts (p < 0.01), and a higher rate of transient lower esophageal sphincter relaxations (p < 0.01). The following parameters contributed significantly (p < 0.01) to a multivariate discriminant analysis: peristalsis amplitude, basal sphincter pressure, rate of transient relaxations of the sphincter, and rate of sphincteric pressure drifts. A correct classification of virtually all cases (97.62%) was reached.

CONCLUSIONS

Motor dysfunctions of both lower esophageal sphincter and esophageal body are the major factors predicting refractoriness of reflux disease in children to a standard medical treatment. Of the two main mechanisms of reflux, i.e., transient lower esophageal sphincter relaxation and lower esophageal sphincter pressure drift, the latter had the highest predictive value for the refractoriness of reflux disease.

Authors+Show Affiliations

Department of Pediatrics, University of Naples "Federico II," Italy.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

8677928

Citation

Cucchiara, S, et al. "Predictive Value of Esophageal Manometry and Gastroesophageal pH Monitoring for Responsiveness of Reflux Disease to Medical Therapy in Children." The American Journal of Gastroenterology, vol. 91, no. 4, 1996, pp. 680-5.
Cucchiara S, Campanozzi A, Greco L, et al. Predictive value of esophageal manometry and gastroesophageal pH monitoring for responsiveness of reflux disease to medical therapy in children. Am J Gastroenterol. 1996;91(4):680-5.
Cucchiara, S., Campanozzi, A., Greco, L., Franco, M. T., Emiliano, M., Alfieri, E., ... Numeroso, V. (1996). Predictive value of esophageal manometry and gastroesophageal pH monitoring for responsiveness of reflux disease to medical therapy in children. The American Journal of Gastroenterology, 91(4), pp. 680-5.
Cucchiara S, et al. Predictive Value of Esophageal Manometry and Gastroesophageal pH Monitoring for Responsiveness of Reflux Disease to Medical Therapy in Children. Am J Gastroenterol. 1996;91(4):680-5. PubMed PMID: 8677928.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Predictive value of esophageal manometry and gastroesophageal pH monitoring for responsiveness of reflux disease to medical therapy in children. AU - Cucchiara,S, AU - Campanozzi,A, AU - Greco,L, AU - Franco,M T, AU - Emiliano,M, AU - Alfieri,E, AU - Calabrese,F, AU - Numeroso,V, PY - 1996/4/1/pubmed PY - 1996/4/1/medline PY - 1996/4/1/entrez SP - 680 EP - 5 JF - The American journal of gastroenterology JO - Am. J. Gastroenterol. VL - 91 IS - 4 N2 - OBJECTIVES: The aim of the study was to evaluate, in 42 children with gastroesophageal reflux disease, the predictive value of both esophageal manometry and gastroesophageal intraluminal pH on the responsiveness of the disease to medical therapy. METHODS: Motility of lower esophageal sphincter and esophageal body was carried out through a perfused pediatric sleeve-probe; prolonged recording of the sphincteric profile was evaluated at the occurrence of reflux episodes as detected by an esophageal electrode; intraluminal pH of the esophagus and stomach was also measured for 24-h through portable equipment. Children were treated for 8 wk with cisapride and ranitidine and were classified as healed or refractory after endoscopy and clinical evaluation. RESULTS: Twenty one children healed, and 21 were refractory. Compared with healed patients, refractory patients showed, at basal evaluation, an increased esophageal acid exposure (p < 0.05), a reduced basal sphincteric pressure and peristalsis amplitude (p < 0.01), an increased rate of sphincteric pressure drifts (p < 0.01), and a higher rate of transient lower esophageal sphincter relaxations (p < 0.01). The following parameters contributed significantly (p < 0.01) to a multivariate discriminant analysis: peristalsis amplitude, basal sphincter pressure, rate of transient relaxations of the sphincter, and rate of sphincteric pressure drifts. A correct classification of virtually all cases (97.62%) was reached. CONCLUSIONS: Motor dysfunctions of both lower esophageal sphincter and esophageal body are the major factors predicting refractoriness of reflux disease in children to a standard medical treatment. Of the two main mechanisms of reflux, i.e., transient lower esophageal sphincter relaxation and lower esophageal sphincter pressure drift, the latter had the highest predictive value for the refractoriness of reflux disease. SN - 0002-9270 UR - https://www.unboundmedicine.com/medline/citation/8677928/Predictive_value_of_esophageal_manometry_and_gastroesophageal_pH_monitoring_for_responsiveness_of_reflux_disease_to_medical_therapy_in_children_ L2 - http://www.diseaseinfosearch.org/result/2996 DB - PRIME DP - Unbound Medicine ER -