ENTtoday
  • Home
  • COVID-19
  • Practice Focus
    • Allergy
    • Facial Plastic/Reconstructive
    • Head and Neck
    • Laryngology
    • Otology/Neurotology
    • Pediatric
    • Rhinology
    • Sleep Medicine
  • Departments
    • Issue Archive
    • TRIO Best Practices
      • Allergy
      • Facial Plastic/Reconstructive
      • Head and Neck
      • Laryngology
      • Otology/Neurotology
      • Pediatric
      • Rhinology
      • Sleep Medicine
    • Career Development
    • Case of the Month
    • Everyday Ethics
    • Health Policy
    • Legal Matters
    • Letter From the Editor
    • Medical Education
    • Online Exclusives
    • Practice Management
    • Resident Focus
    • Rx: Wellness
    • Special Reports
    • Tech Talk
    • Viewpoint
    • What’s Your O.R. Playlist?
  • Literature Reviews
    • Allergy
    • Facial Plastic/Reconstructive
    • Head and Neck
    • Laryngology
    • Otology/Neurotology
    • Pediatric
    • Rhinology
    • Sleep Medicine
  • Events
    • Featured Events
    • TRIO Meetings
  • Contact Us
    • About Us
    • Editorial Board
    • Triological Society
    • Advertising Staff
    • Subscribe
  • Advertise
    • Place an Ad
    • Classifieds
    • Rate Card
  • Search

What Is the Best Test for Pediatric Gastroesophageal Reflux Disease?

by Robert F. Yellon, MD, and Alka Goyal, MD • September 7, 2014

  • Tweet
  • Email
Print-Friendly Version

Trio Best PracticeBackground

Gastroesophageal reflux disease (GERD) in the pediatric population is associated with problems including esophagitis, irritability, Sandifer syndrome, Barrett esophagus, apnea, asthma, cough, dental erosions, dysphagia, laryngitis, pharyngitis, and aspiration. GERD may possibly be associated with sinusitis, otitis media with effusion, laryngomalacia, and subglottic stenosis, but definitive evidence is lacking for these associations. The diagnosis of GERD in an irritable infant with clinical signs and symptoms of regurgitation, who has no other red flags, can have a trial of empiric medical therapy without further testing. The diagnosis of GERD is less clear in some children with the entities listed above, and a variety of tests for the diagnosis of GERD are available. These tests include: 1) A 24-hour pH probe (pHP); 2) Multichannel Esophageal Intralumenal Impedance Testing (MII); 3) upper gastrointestinal study (UGI); 4) Nuclear Medicine Gastric Emptying Scintigraphy (GES); 5) Esophagoscopy and Biopsy (EBx). Each of these tests for diagnosis of GERD in the pediatric population has advantages and limitations, and none of them are ideal for all patient situations. In this review, the advantages and disadvantages of each of these tests will be presented to assist the clinician in choosing the best test for each child with the suspected diagnosis of GERD.

You Might Also Like

  • Pediatric Extraesophageal Reflux Disease: A Diagnostic Dilemma
  • Pepsin Test Can Better Detect Aspiration Reflux, Chronic Lung Disease
  • Gastroesophageal Reflux Management
  • Reviewers ID Reflux Disease Clinical Guidelines
Explore This Issue
August 2014

Best Practice

The pHP was long considered the “gold standard” for diagnosis of GERD, but recent evidence indicates that pHP-MII is superior. Due to some limitations in the standardization of test results, pHP-MII is currently indicated for intractable patients and for correlation of symptoms with reflux episodes. Careful history and physical exam are essential to rule out red flags that mimic GERD before a trial of empiric therapy. Other entities can mimic or be associated with GERD that will not be detected by pHP-MII. Thus UGI, EBx, and GES have limited but specific roles for the diagnosis of GERD and entities such as failed fundoplication, structural abnormalities of the esophagus, eosinophilic esophagitis, and delayed gastric emptying. Read the full article in The Laryngoscope.

Filed Under: Laryngology, Laryngology, Pediatric, Pediatric, Practice Focus, TRIO Best Practices Tagged With: pediatrics, refluxIssue: August 2014

You Might Also Like:

  • Pediatric Extraesophageal Reflux Disease: A Diagnostic Dilemma
  • Pepsin Test Can Better Detect Aspiration Reflux, Chronic Lung Disease
  • Gastroesophageal Reflux Management
  • Reviewers ID Reflux Disease Clinical Guidelines

The Triological SocietyENTtoday is a publication of The Triological Society.

The Laryngoscope
Ensure you have all the latest research at your fingertips; Subscribe to The Laryngoscope today!

Laryngoscope Investigative Otolaryngology
Open access journal in otolaryngology – head and neck surgery is currently accepting submissions.

Classifieds

View the classified ads »

TRIO Best Practices

View the TRIO Best Practices »

Top Articles for Residents

  • Do Training Programs Give Otolaryngology Residents the Necessary Tools to Do Productive Research?
  • Why More MDs, Medical Residents Are Choosing to Pursue Additional Academic Degrees
  • What Physicians Need to Know about Investing Before Hiring a Financial Advisor
  • Tips to Help You Regain Your Sense of Self
  • Should USMLE Step 1 Change from Numeric Score to Pass/Fail?
  • Popular this Week
  • Most Popular
  • Most Recent
    • The Dramatic Rise in Tongue Tie and Lip Tie Treatment
    • Vertigo in the Elderly: What Does It Mean?
    • Experts Delve into Treatment Options for Laryngopharyngeal Reflux
    • Some Laryngopharyngeal Reflux Resists PPI Treatment
    • New Developments in the Management of Eustachian Tube Dysfunction
    • Vertigo in the Elderly: What Does It Mean?
    • New Developments in the Management of Eustachian Tube Dysfunction
    • Some Laryngopharyngeal Reflux Resists PPI Treatment
    • Eustachian Tuboplasty: A Potential New Option for Chronic Tube Dysfunction and Patulous Disease
    • The Dramatic Rise in Tongue Tie and Lip Tie Treatment
    • Why Virtual Grand Rounds May Be Here to Stay
    • Otolaryngologist Leverages His Love of Pinball into Second Business
    • These New Imaging Advances May Help to Protect Parathyroids
    • Is the Training and Cost of a Fellowship Worth It? Here’s What Otolaryngologists Say
    • Which Otologic Procedures Poses the Greatest Risk of Aerosol Generation?

Polls

Have you used 3D-printed materials in your otolaryngology practice?

View Results

Loading ... Loading ...
  • Polls Archive
  • Home
  • Contact Us
  • Advertise
  • Privacy Policy
  • Terms of Use

Visit: The Triological Society • The Laryngoscope • Laryngoscope Investigative Otolaryngology

Wiley
© 2021 The Triological Society. All Rights Reserved.
ISSN 1559-4939

loading Cancel
Post was not sent - check your email addresses!
Email check failed, please try again
Sorry, your blog cannot share posts by email.
This site uses cookies: Find out more.