ArticleChildren (Basel, Switzerland)2025
Comprehensive Assessment of Reflux Burden and Mucosal Integrity in Children: Insights from MNBI and Impedance-pH Monitoring.
Article in Children (Basel, Switzerland), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundPediatric gastroesophageal reflux disease (GERD) presents with heterogeneous phenotypes across ages, and diagnostic challenges persist. Multichannel intraluminal impedance and pH (MII-pH) monitoring is the current gold standard, while mean nocturnal baseline impedance (MNBI) has emerged as a marker of mucosal integrity in adults. Pediatric normative data are still lacking. We aim to characterize age-related reflux patterns and assess the association between MNBI and pathological acid exposure in children undergoing MII-pH monitoring.
methodsWe retrospectively analyzed 226 children evaluated with 24 h MII-pH monitoring between 2017 and 2025. Clinical and laboratory data were reviewed. Children were stratified by age (<1 year vs. ≥1 year). Pathological reflux was defined as reflux index (RI) > 10% in infants and >7% in older children. MNBI was measured at distal channels (Z5, Z6) during nocturnal recumbency. Correlations between MNBI and RI were assessed. Diagnostic performance of MNBI for pathological acid exposure was evaluated using ROC analysis.
resultsInfants had more total reflux episodes, particularly weakly acidic and liquid, whereas older children exhibited more gas reflux. MNBI correlated inversely with RI (Z6 r = -0.337; Z5 r = -0.281; both
conclusionsMNBI is a reproducible, age-sensitive marker of reflux burden in children, best suited for older children where it complements RI in diagnosing acid-mediated GERD. Larger prospective studies are needed to establish pediatric reference values.
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