Open AccessAbnormal 24‐hour pH‐impedance Testing Does Not Predict Reduced Quality of Life in Children With Reflux Symptoms
Author(s) -
Mahoney Lisa B.,
Mitchell Paul D.,
Fishman Eliza,
Lurie Margot,
Rosen Rachel
Publication year - 2020
Publication title -
journal of pediatric gastroenterology and nutrition
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.206
H-Index - 131
eISSN - 1536-4801
pISSN - 0277-2116
DOI - 10.1097/mpg.0000000000002495
Subject(s) - medicine , esophagogastroduodenoscopy , reflux , quality of life (healthcare) , gerd , esophagitis , medical diagnosis , disease , gastroenterology , severity of illness , prospective cohort study , cross sectional study , physical therapy , pediatrics , endoscopy , pathology , nursing
Objectives: Symptoms of gastroesophageal reflux (GER) have been associated with reduced health‐related quality of life (QOL) in children, though it is unclear whether reflux burden on objective diagnostic testing, such as 24‐hour multichannel intraluminal impedance with pH (pH‐MII) is associated with impaired QOL in children. Our aim was to identify predictors of QOL impairment based on the results of esophageal reflux testing. Methods: In this prospective, cross‐sectional study of children undergoing pH‐MII and esophagogastroduodenoscopy (EGD) for evaluation of suspected gastroesophageal reflux disease, we collected validated questionnaires (Pediatric Gastroesophageal Symptom and Quality of Life Questionnaire [PGSQ], Pediatric Quality of Life Inventory 4.0 [PedsQL] and PedsQL Gastrointestinal Symptoms Module [GI PedsQL]) to determine the relationship between objective measures of GER, patient‐reported symptoms and QOL outcomes. Results: Of the 82 subjects, 38% of children had an abnormal pH‐MII study. There were no significant differences in QOL scores on any questionnaire between patients with normal and abnormal pH‐MII studies ( P > 0.11). There was no correlation between individual pH‐MII parameters and QOL scores. Subjects with gross esophagitis on EGD reported significantly worse QOL with lower total PedsQL ( P = 0.002) and GI PedsQL ( P = 0.03) scores. Microscopic esophagitis was not associated with differences in QOL scores ( P > 0.32). Conclusions: There was no relationship between abnormalities on pH‐MII testing and reduced QOL in children. These findings highlight the importance of considering other diagnoses beyond GERD as they may be significant drivers for QOL impairment.