What is the role of intraesophageal pH probe monitoring in the workup of pediatric gastroesophageal reflux disease (GERD)?

Updated: Mar 14, 2019
  • Author: Steven M Schwarz, MD, FAAP, FACN, AGAF; Chief Editor: Carmen Cuffari, MD  more...
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Although pH monitoring has become a widely overused modality, it remains the criterion standard for quantifying gastroesophageal reflux.

A continuous esophageal pH probe in the distal esophagus documents the severity and frequency of reflux. Although this is a very sensitive monitoring modality, some controversy persists with respect to the precise criteria for differentiating physiologic from pathologic gastroesophageal reflux. More recently, dual pH probe monitoring has come into use to assess distal and proximal esophageal reflux in an attempt to correlate gastroesophageal reflux with laryngeal and pulmonary symptoms.

Advantages in using pH monitoring include the quantification of reflux and the ability to establish a temporal relationship with atypical symptoms (eg, obstructive apnea) and reflux events.

Esophageal pH monitoring is not indicated in cases of obvious gastroesophageal reflux but is useful in demonstrating an association between reflux and symptoms in atypical presentations and in grading the risk of esophagitis.

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