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PREDICTION OF SEVERITY OF REFLUX ESOPHAGITIS BY COMPUTED 24 HOUR pH MONITORING

Kostovski A

Pediatric Clinic, Faculty of Medicine, Skopje, Macedonia, Europe

Objective: The aim of the study was to correlate the values of computed 24 hour pH monitoring (C24hpHM) in control group children without reflux esophagitis (RE) with a group with endoscopically proven RE. Second, to see which C24hpHM parameters are predictors of severity of RE.

Methods: In a prospective study were evaluated 33 children for the presence of gastroesophageal reflux (GER) and RE. They were separated in two groups: Control group without RE (17 children, age 116+/-31 months, male to female ratio 10/7), and RE group (16 children, age 120+/-47 months, male to female ratio 10/6). C24hpHM was performed with Digitrapper Mark III, Sinectics, Sweden. Positive for GER was considered if percentage of time pH<4 (PTpH<4) was >5%. By Gastrosoft softver were evaluated the following parameters: number of reflux episodes (NRE), number of reflux episodes>5 min (NRE>5), the longest reflux episodes (LRE), PTpH<4, reflux index (RI), esophageal clearance (EC), symptom index (SI), mean pH value (MpHV), acid reflux area (ARA), and oscillatory index (OI). RE was graded as mild and severe.

Results: We found significant statistical difference for all C24hpHM parameters between control and RE group. Besides hemathemesis and hiatal hernia there was also significant statistical difference between mild and severe RE for: NRE>5, LRE, PTpH<4, EC, MpHV, ARA (p<0.05).

Conclusion: Our results showed that predictors of severe RE are the long lasting episodes (NRE>5, LRE), impaired acid clearance (EC), higher acidity (MpHV, and ARA) after what upper endoscopy should be performed.