The ESPGHAN Pediatric Impedance Group (PIG) has published a review/consensus statement on the use of pH-Impedance monitoring (MII-pH) in children (JPGN 2012; 55: 230-34).
Conclusions from this group:
- MII-pH provides more information than conventional pH probe. Whether this information will “inform prognosis, or predict response to therapy in pediatric patients has yet to be determined”
- ‘As long as there is no effective medical therapy for weakly acid and nonacid reflux, the clinical relevance of MII-pH remains debatable’
- “There are no data on the results of antireflux surgery based solely on the detection of weakly acid and nonacid reflux”
- MII-pH is investigational technique needing standardization before routine diagnostic use can be recommended.
- Major indications: need to identify weakly acid and nonacid reflux, persisting symptoms during antireflux treatment, use in identifying rumination syndrome, and research
- Limitations of MII-pH: high cost, limited contribution to change in medical care, lack of evidence-based parameters for assessment of GER
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