IS THERE A ROLE FOR THE PROXIMAL pH PROBE WHEN DIAGNOSING GASTROESOPHAGEAL REFLUX IN CHILDREN?

Abstract

15 INTRODUCTION: Extended 24-hour intraesophageal pH monitoring is the gold standard to diagnose GER. A range of normal values for the distal reflux index (DRI) is well established. However, limited data are available regarding a range of normal values for the proximal reflux index (PRI) and its clinical significance. OBJECTIVES: To establish a range of normal values for the proximal pH probe and to assess the clinical usefulness of the proximal pH probe data. METHODS: A retrospective study of 189 pediatric 24 hour esophageal dual pH probe studies carried out at our hospital during the last 5 years. The proximal pH probe was located 5 cm from the distal probe. The DRI and PRI were calculated as the percentage of time, esophageal pH was < 4.0 at the distal and proximal probes respectively. There were 114 negative studies (DRI < 5%) and 75 positive studies (DRI >5%). For the determination of normal values for PRI only 81 patients of the 114 negative studies were utilized because of artifact in the other 33 negative studies. RESULTS: The normal range of values for PRI are as follows: (Table)CONCLUSION: We established a reference range of normal values for the proximal pH probe. Although further studies are needed, the current data suggest that the proximal pH probe does not add clinically significant information.TABLE