In both kids and adults, individuals presenting with complaints of reflux more often have other problems like functional heartburn or reflux hypersensitivity (see posts below). A recent prospective, cross-sectional study (LB Mahoney et al. JPGN 2020; 70: 31-36) provides data that further shows that abnormal pH-impedance (pH-MII) testing does NOT predict reduced quality of life (QOL) in children with reflux symptoms (n=82).
- 38% had abnormal pH-MII testing; however, there were no significant differences in QOL scores on any of the tested questionairres between those with normal or abnormal pH-MII studies.
- Subjects with gross esophagitis on EGD reported significantly worse QOL scores. Microscopic esophagitis was not associate with differences in QOL scores.
The implication of this study is that reflux without esophagitis is NOT a driver of abnormal QOL parameters; instead, functional GI disorders are likely more important.
My take: This study makes it clear that gross endoscopic findings are much more consequential than abnormal pH-MII studies.
Related blog posts:
- What’s Going On in Patients with Reflux Who Fail to Respond to PPIs?
- How Many Kids with Reflux Actually Have Reflux?
- How to Make a Study Look Favorable to Surgery for Reflux over Medical Therapy
- Why didn’t patient with documented reflux get better with PPI …
- Failure of PPI test | gutsandgrowth
- Guidelines on Functional Heartburn
- Better to do a coin toss than an ENT exam to determine reflux
- How Likely is Reflux in Infants with “Reflux-like … – gutsandgrowth
- PPI Webinar
- The Connection Between Anxiety and Gastroesophageal Reflux Disease
- pH Probe Testing: Rumors of My Death Are Premature