Assessment of physiological values of gastroesophageal reflux in children by using combined multi-channel intraluminal impedance and pH monitoring

Gastroesophageal reflux (GOR) is a normal phenomenon that occurs in children and adults after meals, mostly asymptomatic and lasting less than 3 minutes. The prevalence is 50% and 5% at 3 months and 1 year of age, respectively. Diagnosis is with multi-channel intraluminal impedance-pH (MII-pH) study. Our aim is to evaluate the physiological values of MII-pH in children less than 16 years of age. Two groups, infants less than 1 year old and older children 1-16 years, were studied separately. We also studied group 1-6 years of age to study the age effect. We used the MII-pH analysis results of patients with no risk factors for Gastroesophageal reflux disease (GORD) who were referred for assessment of GORD during the study period to calculate the mean ± 2SD deviations (or the median if data are skewed), which we propose to be the near-normal values. Out of 1,183 patients, 849 were enrolled. Data distribution was skewed. We found that our population's values are in general different from the currently used ones. Our data showed that total reflux episodes (in the children group only), acid exposure time and percentage of exposure more than 5 minutes (in both groups) are all higher than the currently used values. We found no age effect between older and young children 1-6 years of age. To our knowledge, this is the largest study to assess normal values of GOR in paediatrics to date. Our study showed that currently used values could over-diagnose GORD in children.