Twenty-four-hour esophageal intraluminal pH probe testing: A comparative analysis

Abstract

Twenty-four-hour esophageal intraluminal pH probe studies were performed in 49 infants and children, 22 of whom were asymptomatic. Seventeen different parameters dealing with gastroesophageal reflux were analyzed during these 24-h pH probe studies. Unlike previous investigations the symptomatic patients differed from the asymptomatic ones in the vast majority of these parameters. The symptomatic patients were significantly different from the asymptomatic ones in 13 of the 17 parameters examined. The four parameters in which the two groups were similar included the number of reflux episodes which occurred while eating, the total number of crying episodes per day, the number of reflux episodes associated with these episodes of crying, and the average duration of episodes of esophageal pH < 4 which occurred while the children were asleep. Comparisons were made between the 24-h pH probe studies and three other testing modalities; the 1-h pH probe study, esophageal manometrics, and radiographic studies of the esophagus. Twenty-one of the 27 symptomatic patients had a positive 1-h pH probe study. All asymptomatic ones had a negative 1-h pH probe examination. Lower esophageal sphincter pressures were similar in both groups, and radiographic studies were also documented to be neither sensitive nor specific. It was found that the 24-h pH probe study was useful in the evaluation of various pediatric problems associated with gastroesophageal reflux, particularly those dealing with recurrent pulmonary infections and apneic spells. Two group multivariate discriminant analysis was done in a step-down variable selection mode. This evaluation of the two groups yielded a simplified formula involving only two variables, which allows rapid and accurate analysis of this type of pH probe study.