[size=20px]Which diagnostic study best assesses gastroesophageal reflux and its association with patient symptoms?

 

A Transpyloric feeding trial

 

B Esophagogastroduodenoscopy (EGD)

 

C Upper gastrointestinal series

 

D pH multichannel intraluminal impedance (pH-MII) study

 

E Gastric scintigraphy​[/size]

D

D

D

pH multichannel intraluminal impedance (pH-MII) study

C Upper gastrointestinal series

D. pH multichannel intraluminal impedance (pH-MII) study

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d

correct answer

D pH multichannel intraluminal impedance (pH-MII) study

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The management of gastroesophageal reflux in infants and children is controversial. The best test to correlate gastroesophageal reflux events with patient symptoms is a pH multichannel intraluminal impedance (pH-MII) study. Upper gastrointestinal series can be considered to rule out structural anomalies, such as a hiatal hernia. Gastric scintigraphy may be helpful for assessing motility disorders but not reflux. Upper endoscopy may be helpful to assess complications of gastroesophageal reflux and rule out eosinophilic esophagitis but it does not directly correlate reflux events and patient symptoms. Similarly, a trial of transpyloric feeding may predict success of fundoplication but does not evaluate reflux events directly like a pH-MII study.​

 

 

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