EXTRAESOPHAGEAL PEDIATRIC REFLUX - 24-HOUR DOUBLE-PROBE PH MONITORINGOF 222 CHILDREN

Although extraesophageal gastric reflux has been implicated as a cause of many pediatric airway and respiratory diseases, its prevalence in these conditions remains unknown due to the relative lack of sensitivi ty and/or specificity of traditional reflux testing methods. A prospec tive study of 222 children (ages 1 day to 16 years) was performed with 24-hour double-probe (simultaneous esophageal and pharyngeal) pH moni toring. Seventy-six percent (168/222) of the study population had abno rmal findings in either one or both of the pH probes. Of those, 46% (7 8/168) had pharyngeal reflux (extraesophageal gastric acid documented by the pharyngeal probe), despite having normal esophageal acid exposu re times according to the esophageal probe. Thus, had the pharyngeal p robe not been used, 46% of the children with documented extraesophagea l (pharyngeal) reflux would have been falsely presumed to have normal reflux parameters. Patients with laryngeal abnormalities, pulmonary ab normalities, and emesis had significantly more pharyngeal acid reflux (p < .001) than patients with nonrespiratory symptoms. These data sugg est that extraesophageal reflux may be underestimated by single-probe intraesophageal monitoring alone, and that laryngopharyngeal reflux ma y play a role in the pathogenesis of the conditions studied.