Clinical value of wireless pH-monitoring of gastro-esophageal reflux in children before and after proton pump inhibitors (BMC Gastroenterology)

Background: Wireless pH-monitoring is an accurate method for diagnosing adults with gastroesophageal reflux disease (GERD). The aim of this study was to evaluate the use of the Bravo capsule on children investigated for GERD in terms of safety, tolerability and feasibility before and after administration of proton pump inhibitors. Methods: A Bravo capsule was inserted during upper endoscopy under general anaesthesia or deep sedation with propofol. 48-hour pH-metry was performed in 106 children (50 males, 56 females) at the median age of 11?years (range 17?months-18?years). On the second day of investigation, proton pump inhibitor (PPI) was given at a mean dose of 1.6?mg/kg (SD ?0.6?mg). The definition of GERD was set to a reflux index (RI) of ?5% and DeMeester score (DMS) ?14.7. Results: Application of the capsule was successful in 103 of the 106 children (97.2%) and interpretable in 99 of these 103 (96.1%). 49 of the children with interpretable results (49.5%) had GERD according to RI, while 51 (56.7%) had GERD according to DMS. After PPI was given on day 2, RI decreased from a median of 4.9% (range 0.3-63.4%) to 2.2% (0?58.0%), while DMS decreased from a median of 17.6 (range 2.2-207.6) to 8.2 (0.3-178.6), respectively (p