Dual-Channel pH Probe Is Not Distinctive in Children with Respiratory Symptoms

Abstract

Gastroesophageal reflux is considered one of the etiologies for chronic respiratory and laryngeal symptoms in infants and children, yet the association has been difficult to prove. Dual-channel 24-hour pH probe studies have become more common in the evaluation of these children. To establish whether a significant correlation exists between pharyngeal acid exposure and chronic respiratory symptoms in children, 293 infants and children with and without respiratory symptoms underwent 24-hour double pH probe monitoring. Patients were divided into four groups based on the clinical indication for the study and the results of the distal sensor. Pharyngeal reflux episodes correlated positively (r = 0.54) with lower esophageal episodes but did not differentiate children with respiratory symptoms from those with nonrespiratory symptoms. There was an inverse relation between the number of pharyngeal reflux episodes (r = -0.14) and age, making the definition of abnormal pharyngeal reflux age dependent. The evaluation for pharyngeal acid does not supplant or replace studies of the distal esophagus in children with chronic respiratory symptoms. In addition, the mechanism for acid-induced respiratory symptoms in children requires more intensive investigation than a pH probe study.