Prospective Study
Copyright ©The Author(s) 2023.
World J Clin Pediatr. Jun 9, 2023; 12(3): 151-161
Published online Jun 9, 2023. doi: 10.5409/wjcp.v12.i3.151
Table 1 Demographic characteristics and parameters from Multichannel intraluminal impedance-pH study in children diagnosed with extraesophageal gastroesophageal reflux disease and no extraesophageal gastroesophageal reflux disease, n, (%)
CharacteristicsNo extraesophageal GERD (n = 33)Diagnosed extraesophageal GERD by MII-pH study (n = 18)P value
Univariable analysis
Multivariable analysis
Age (yr) (median, IQR)1.67 (0.91, 3.38)4.58 (1.70, 13.15)0.174
Age < 1 yr10 (30.3)2 (11.1)
Age ≥ 1 yr23 (69.7)16 (88.9)
Sex, male17 (51.5)10 (55.6)1
Underlying diseases0.441
Respiratory disorder
Bronchiectasis1 (3.03)0
Chronic lung disease7 (21.21)2 (11.11)
Congenital hypoventilation syndrome02 (11.11)
Subglottic stenosis01 (5.56)
Tracheobronchomalacia1 (3.03)0
Laryngomalacia1 (3.03)0
BRUE1 (3.03)0
Chronic cough1 (3.03)0
Neurological disorder
Swallowing dysfunction2 (6.06)1 (5.56)
Spastic cerebral palsy2 (6.06)3 (16.67)
Infantile spasm1 (3.03)0
Multiple anomalies
Syndromic disorder6 (18.18)2 (11.11)
Non-syndromic disorder9 (27.27)7 (38.89)
Indication for evaluation
Extraesophageal symptoms0.679
Recurrent pneumonia9 (27.3)4 (22.2)
Hypersecretion4 (12.1)2 (11.1)
Cough11 (33.3)10 (55.6)
Glossoptosis1 (3.0)0
Tracheobronchomalacia1 (3.0)0
Stridor1 (3.0)0
Choking4 (12.1)1 (5.6)
Chronic rhinosinusitis01 (5.6)
BRUEs1 (3.0)0
Apnea1 (3.0)0
Esophageal symptoms0.293
Vomiting8 (24.2)6 (38.9)
Heartburn1 (3.0)1 (5.6)
None24 (72.7)11 (61.1)
Total recorded symptoms (times, %)941710.0330.064
Cough43 (45.75)66 (38.60)0.404
Irritability32 (34.04)22 (12.86)0.754
Apparent secretion7 (7.44)17 (9.94)0.346
GI symptoms (vomiting or heartburn)12 (12.77)66 (38.60)0.081
Impedance parameters (median, IQR)
Total time (hours)22.12 (20.34, 24.04)21.34 (19.97, 22.62)0.391
Reflux index10.40 (0, 1.45)8.4 (4.43, 14.20)0.001
Longest reflux time (min)1.3 (0, 4.30)17.2 (9.43, 38.55)0.001
Total reflux events112 (5.00, 37.50)28 (18.50, 45.50)0.0320.012
Weakly acid reflux events
Acid reflux events9 (2.50, 27.00)10 (3.75, 21.75)0.79
Nonacid reflux events1 (0, 4.50)15.5 (8.75, 25.25)0.001
Symptom indices0 (0, 4.00)0 (0,1.00)0.3810.212
Symptom index10 (0, 0.00)0 (0, 12.73)0.208
Symptom sensitivity index10 (0, 0.00)0 (0, 1.40)0.32
Symptom associated index10 (0, 0.00)0 (0, 85.63)0.168
MNBI (ohms) (mean, SD)1897.69 (806.89)1300.48 (600.31)0.008
PSPW (%) (mean, SD)53.57 (27.59)56.11 (15.70)0.721
Diagnosis GERD
Gross finding (n = 25)8/12 (66.7)10/13 (76.9)0.673
Histopathology (n = 22)6/11 (54.5)10/11 (90.9)0.149
Table 2 Comparing symptoms recorded by conventional and combined visual data object -monitoring in children who underwent multichannel intraluminal impedance-pH study (n = 17), n, (%)
Characteristics
Conventional MII-pH study
Combined video-MII-pH study
P value
Total recorded symptoms1202200.062
Cough31 (25.83)46 (20.90)0.259
Irritability38 (31.67)101 (45.90)0.114
Apparent secretion3 (2.50)43 (19.55)0.02
GI symptoms (vomiting or heartburn)48 (40.00)33 (15.00)0.339
Symptom indices (median, IQR)
Symptom index0 (0–5.00)0 (0–11.65)0.306
Symptom sensitivity index0 (0–2.65)0 (0–5.80)0.306
Symptom associated index0 (0–37.60)0 (0–93.15)0.306
Diagnosis GERD using symptom indices2 (11.76)5 (29.41)0.398