Diagnosis of Gastroesophageal Reflux Disease in Children: Comparing Barium Studies with 24-hour Esophageal pH Monitoring
Keywords:
gastroesophageal reflux disease, 24-hour esophageal pH monitoring, barium studiesAbstract
Background: Twenty-four-hour esophageal pH monitoring is a useful investigation for diagnosis of gastroesophageal reflux disease (GERD), however. it is not widely available in developing countries including Thailand. Barium studies are widely available in our country. The objective of this study was to compare the sensitivity and specificity of the modified barium studies in our hospital with the 24-h esophageal pH monitoring for diagnosis of GERD in children.
Subjects and methods: All children suspected of GERD who underwent barium studies and 24-h esophageal pH monitoring within 14 days, during the 7 consecutive-years period. were retrospectively reviewed. Criteria for diagnosis of GERD by 24-h pH monitoring were having fraction time with pH below 4.0 more than 10% in infants and 5% in older children.
Results: Total 159 children met the criteria; 7 cases were excluded due to incomplete data. Comparing to 24-h pH monitoring, barium studies showed a sensitivity, specificity and accuracy of 61.2%. 37.7% and 47.4%, respectively.
Conclusion: Comparing with 24-h esophageal pH monitoring, modified barium examination still has a rather low sensitivity, specificity and accuracy for diagnosis of pediatric GERD. Barium studies may be useful for evaluation of children with clinical suspected of GERD but a limitation for diagnosis of GERD should be aware.
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