Open AccessLow mean impedance in 24‐hour tracings and esophagitis in children: a strong connection
Author(s) -
Salvatore S.,
Salvatoni A.,
Ummarino D.,
Ghanma A.,
Van der Pol R.,
Rongen A.,
Fuoti M.,
Meneghin F.,
Benninga M. Alexander,
Vandenplas Y.
Publication year - 2016
Publication title -
diseases of the esophagus
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.115
H-Index - 63
eISSN - 1442-2050
pISSN - 1120-8694
DOI - 10.1111/dote.12290
Subject(s) - medicine , esophagitis , gastroenterology , reflux , gerd , reflux esophagitis , bolus (digestion) , esophagus , disease
Summary Esophageal multiple intraluminal impedance baseline is an additional impedance parameter that was recently related to esophageal integrity. The aim of this study was to assess the relationship between mean esophageal impedance value and endoscopic findings in a large group of children. Children with symptoms of gastroesophageal reflux submitted to both endoscopy and impedance were included. Esophagitis was graded according to the L os A ngeles classification. Mean impedance value was automatically calculated over 24‐hour tracings. Data were adjusted for age through z ‐score transformation using percentiles normalized by the LMS (Lambda for the skew, Mu for the median, and Sigma for the generalized coefficient of variation) method. Nonparametric M ann– W hitney and K ruskal– W allis tests, multiple, and stepwise regression were used. P ‐value <0.05 was considered as statistically significant. A total of 298 impedance tracings were analyzed. Endoscopic and histological esophagitis were detected in 30 and 29% patients, respectively. Median baseline z ‐score was significantly decreased both in proximal ( P = 0.02) and distal ( P = 0.01) esophagus in patients with endoscopic (but not histological) esophagitis. Patients with more severe esophagitis showed the lowest z ‐score. Bolus exposure index and the number of reflux episodes were the variables that were significantly associated with the baseline z ‐score. Impedance z ‐score is significantly decreased in infants and children with endoscopic esophagitis. Severity of esophagitis, bolus exposure index, and number of reflux episodes are factors influencing mean esophageal impedance.