Objective: To evaluate the diagnostic value and application of 24 h multichannel intraluminal impedance-pH (24 h MII-pH) monitoring in children with gastroesophageal reflux disease (GERD). Methods: This is a cross-sectional study. From January 2013 to December, 2020, 417 patients who received 24 h MII-pH monitoring in Department of Gastroenterology of Children's Hospital Capital Institute of Pediatrics were included. According to results, these children were divided into the GERD and non-GERD groups. Furthermore, the 132 children with GERD who had gastroscopy were divided into the reflux esophagitis (RE) and non-erosive reflux disease (NE) groups to investigate the differences in their refluxes. Non-parametric Mann-Whitney U test or indepentent sample t test was used for comparisons between the groups. Results: Among the 417 children, 232 were males and 185 females, aged (7.3±3.9) years. The course of disease was 0.5 (0.1, 2.0) years. The main clinical symptoms included acid reflux (128 cases), vomiting (173 cases), abdominal pain (101 cases), and cough (76 cases). The 24 h MII-pH monitoring were positive in 243 children (58.3%, 243/417), which was higher than that by 24 h esophageal pH monitoring (43.6%, 182/417). The 24 h MII-pH monitoring results demonstrated significant differences in the episodes of acid reflux, weakly acidic reflux, non-acidic reflux, liquid reflux and mixed reflux between GERD and non-GERD groups (10 (4, 19) vs. 4 (1, 9) times/24 h, 14 (6, 32) vs. 7 (3, 13) times/24 h, 0 (0, 0) vs. 0 (0, 0) times/24 h, 19 (10, 34) vs. 8 (3, 14) times/24 h, and 6 (2, 12) vs. 3 (1, 5) times/24 h, Z=-6.96, -7.25, -5.62, -8.75, and -6.48, all P<0.05, respectively). Besides, the results also showed significant differences in Boix-Ochoa score, episodes of long reflux, course of long reflux, and episodes of weakly acidic reflux between the RE and NE groups (51.2 (21.4, 153.2) vs. 20.7 (12.1, 34.7), 5 (2, 10) vs. 1 (0, 4) times/24 h, 19 (7, 87) vs. 8 (3, 22) min, and 5 (2, 15) vs. 15 (6, 33) times/24 h, Z=-3.44, -3.41, -2.65, and -2.27, all P<0.05, respectively). Conclusion: 24 h MII-pH monitoring not only improves the detection rate of GERD in children, but also provides a possibility to early etiological diagnosis.
Female ; Male ; Humans ; Child ; Cross-Sectional Studies ; Electric Impedance ; Gastroesophageal Reflux/diagnosis* ; Esophageal pH Monitoring ; Hydrogen-Ion Concentration

Objective: To standardize the 12-item reflux symptom scale in Chinese and evaluate its reliability, validity, and effect on diagnoses. Methods: A systematic translation version of the RSS-12 scale was performed using the Brislin model. The scale with 12 items included three dimensions of symptoms in ear, nose and throat, gastrointestinal tract and respiratory tract. The effect was assessed by three aspects containing symptom frequency, severity, and the quality of life. The Chinese version of RSS-12 was used to test 432 patients who attended the outpatient ENT department of Fujian Provincial Hospital between March 2021 and December 2021, and 413 patient questionnaires were classified as valid, aged 17-78(40.8±13.3) years, 203 were female and 210 were male. SPSS 26.0 and AMOS 24.0 statistical software were used to evaluate the performance of the scale. Results: The scale was highly discriminatory among items and correlated well among dimensions. The I-CVI ranged from 0.67 to 1.00, and the S-CVI was 0.81. The exploratory factor analysis showed that the cumulative variance contribution was 63.583%. The validation factor analysis showed that the model adaptation was good, and the correlation coefficient with the RSI was 0.796. Cronbach's α coefficient was 0.814, the retest reliability was 0.939, and the Spearman-Brown half reliability was 0.892, all of which showed a high level of reliability. Using 24h MII-pH as the diagnostic criterion for LPRD, the RSS-12 scale had a diagnostic compliance rate of 79.4%, with a sensitivity of 0.768 and specificity of 0.857. Conclusion: The Chinese version of the RSS-12 scale has good reliability, validity, and diagnostic ability, which can be used as a screening tool to diagnose pharyngeal reflux diseases.
China ; Female ; Gastroesophageal Reflux/diagnosis* ; Humans ; Male ; Quality of Life ; Reproducibility of Results ; Surveys and Questionnaires ; Translations

OBJECTIVE: To analyze the differences in reflux patterns in 24-hour esophageal pH-impedance monitoring in patients with non-erosive reflux disease (NERD), reflux hypersensitivity (RH) and functional heartburn (FH) and explore the possible mechanism of symptoms in patients with heartburn and negative endoscopic findings. METHODS: Seventy-nine patients with heartburn as the main symptoms but negative endoscopic findings, including 35 with NERD, 16 with RH and 28 with FH, were enrolled in this study.All the patients underwent 24-h esophageal pH-impedance monitoring and esophagogastroscopy, and the results were compared among the 3 groups. RESULTS: Acid reflux episode was significantly increased and weakly alkaline reflux episode was significantly decreased in NERD group in comparison with RH group and FH group ( CONCLUSIONS Patients with NERD, RH and FH had different reflux patterns.Acid reflux is predominant in the NERD, while weakly alkaline reflux is significantly increased RH and FH.In patients with normal esophageal acid exposure but without symptoms or without recorded symptoms during esophageal pH-impedance monitoring, analysis of the total reflux episode, mixed reflux episode, proximal acid reflux episode and percentage can help in the differential diagnosis between RH and FH.
Electric Impedance ; Esophageal pH Monitoring ; Gastroesophageal Reflux/diagnosis* ; Heartburn/etiology* ; Humans ; Hydrogen-Ion Concentration

reflux diseases and eosinophilic bronchitis were less frequently observed. Following the KATRD cough-management guidelines, 91.2% of the subjects improved after 4 weeks of treatment. Responders were younger, had a longer duration of cough, and an initial impression of CVA. In univariate and multivariate analyses, an initial impression of CVA was the only factor related to better treatment response.CONCLUSION: The causes of chronic cough in Korea differed from those reported in other countries. The current Korean guidelines proved efficient for treating Korean patients with chronic cough.]]>
Asthma ; Bronchitis ; Cohort Studies ; Cough ; Diagnosis ; Disease Management ; Eosinophils ; Epidemiology ; Female ; Gastroesophageal Reflux ; Humans ; Korea ; Lung Diseases ; Multivariate Analysis ; Observational Study ; Pregnant Women ; Retrospective Studies ; Tuberculosis

No abstract available.
Diagnosis ; Gastroesophageal Reflux

Gastroesophageal reflux disease (GERD) is diagnosed according to the medical history or in response to proton pump inhibitor therapy. However, the need for further testing is always appropriate. The decisive evidence for the current diagnosis of GERD is severe erosive esophagitis of Los Angeles grade C or D, long-segment Barrett's mucosa or peptic strictures seen on endoscopy or an acid exposure time >6% on ambulatory pH or pH impedance monitoring. If ambulatory reflux monitoring correlates between reflux and the symptoms, then the diagnosis and treatment are certain. If it is difficult to clearly diagnose this malady as seen upon endoscopy and ph/pH impedance monitoring, then this review recommends the biopsy findings, motor evaluation and novel impedance metrics. Novel impedance metrics include the baseline impedance and the post reflux swallow-induced peristaltic wave index. Therefore, making a future GERD diagnosis should focus on defining the patient's phenotype. The phenotype is determined by the level of reflux exposure, clearance efficacy, anatomy of the esophageal gastric junction, and the psychological state of the patient. The purpose of this review is to clarify the diagnostic guideline for GERD according to several test methods.
Biopsy ; Consensus ; Constriction, Pathologic ; Diagnosis ; Electric Impedance ; Endoscopy ; Esophageal pH Monitoring ; Esophagitis ; Gastroesophageal Reflux ; Humans ; Hydrogen-Ion Concentration ; Manometry ; Mucous Membrane ; Phenotype ; Proton Pumps

No abstract available.
Diagnosis ; Gastroesophageal Reflux

Esophageal cancer is an aggressive malignant tumor with a poor prognosis because of its typically advanced stage at diagnosis and treatment-related morbidity and mortality. Of the two major subtypes, esophageal squamous cell carcinoma (ESCC) and esophageal adenocarcinoma, ESCC is prevalent in more than 90 percent of esophageal cancer patients in Korea. Both the incidence and mortality of esophageal cancer are declining, and the relative survival rate of patients with esophageal cancer has improved. These epidemiological changes are attributed to increase in the detection rate of esophageal cancer at localized and regional stages before distant spread of the disease. And the most well-known risk factors for esophageal adenocarcinoma are obesity and gastro-esophageal reflux disease. The carcinogenesis of ESCC is associated with chronic irritation caused by smoking, heavy alcohol use, drinking very hot beverages, and a low socioeconomic status. Understanding the risk factors for esophageal cancer can lead to the identification of preventative strategies to reduce the risk of developing esophageal cancer or to improve the long-term prognosis.
Adenocarcinoma ; Beverages ; Carcinogenesis ; Carcinoma, Squamous Cell ; Diagnosis ; Drinking ; Epidemiology ; Esophageal Neoplasms ; Gastroesophageal Reflux ; Humans ; Incidence ; Korea ; Mortality ; Obesity ; Prognosis ; Risk Factors ; Smoke ; Smoking ; Social Class ; Survival Rate

BACKGROUND/AIMS: The Gastroesophageal Reflux Disease Questionnaire (GerdQ) has been developed and validated as a tool for the diagnosis of gastroesophageal reflux disease (GERD) in patients with gastrointestinal symptoms. However, the GerdQ and the cutoff value for determining GERD has not been validated in Korea. METHODS: Patients with symptoms suggestive of GERD were consecutively recruited. The Korean version of GerdQ was developed through a forward-backward translation process according to the cross-cultural adaptation method. Endoscopically documented esophagitis, abnormal results on 24-hour ambulatory pH recording with symptom association monitoring, or response to proton pump inhibitor treatment were used as diagnostic references for GERD. The reproducibility and test characteristics of the Korean version of GerdQ were assessed. RESULTS: A total of 149 patients with a median age of 55 years were analyzed. The intra-class correlation coefficient of 2 subsequently measured GerdQ scores was 0.651 (95% CI, 0.518–0.748). The cutoff value of 8 was found to have the highest sensitivity (64.9%; 95% CI, 56.2–73.7) and specificity (71.4%; 95% CI, 56.5–86.4) for the diagnosis of GERD. The questionnaire had a high positive predictive value (88.1%; 95% CI, 81.2–95.0), but a low negative predictive value (38.5%; 95% CI, 26.2–50.3) for GERD. Any symptom improvement on proton pump inhibitor treatment showed a sensitivity of 93.0% (95% CI, 88.3–97.7) and a specificity of 48.6% (95% CI, 32.0–65.1) for GERD. CONCLUSION: The Korean version of GerdQ is a useful complementary tool in the diagnosis of GERD.
Diagnosis ; Esophagitis ; Gastroesophageal Reflux ; Humans ; Hydrogen-Ion Concentration ; Korea ; Methods ; Proton Pumps ; Sensitivity and Specificity ; Surveys and Questionnaires ; Symptom Assessment

The diagnosis and management of gastro-esophageal reflux (GER) and GER disease (GERD) in infants and children remains a challenge. Published guidelines and position papers, along with Embase, MEDLINE, and the Cochrane Database were reviewed and summarized with the intent to propose a practical approach and management of GER and GERD for healthcare providers and to standardize and improve the quality of care for infants and children. For this purpose, 2 algorithms were developed, 1 for infants < 12 months of age and the other for older children. None of the signs and symptoms of GER and GERD are specific and there is no gold standard diagnostic test or tool. Nutritional management is recommended as a first-line approach in infants, while in children, a therapeutic trial with antacid medication is advised for early management. The practical recommendations from this review are intended to optimize the management of GER in infants and older children and reduce the number of investigations and inappropriate use of medication.
Child ; Diagnosis ; Diagnostic Tests, Routine ; Electric Impedance ; Endoscopy ; Esophagitis ; Gastroesophageal Reflux ; Health Personnel ; Humans ; Hydrogen-Ion Concentration ; Infant ; Proton Pump Inhibitors