Indicazioni alla pH-metria esofagea. Abbiamo modificato il nostro comportamento negli ultimi 18 anni?

Aims: We reviewed the procedures performed during the last 18 years at the Pediatric Department of the University of Verona (Italy) to investigate how the clinical use of esophageal pH monitoring (EpHM) to diagnose gastroesophageal reflux disease has changed in our practice. Methods: Data of EpHM from January 1990 to December 2007 were reviewed and the year in which the procedure was done, age of patients, clinical indication to the procedure and EpHM outcome were recorded. Results: Eight hundred and twenty-two procedures were performed in 775 children. Children < 1 year of age were 39.6%, but they decreased from 72% in 1990-92 to 27% in 2005-07 (p < 0.001). Indications to EpHM were gastrointestinal in 55%, respiratory in 40% and different in 5% of children. EpHM was more frequently abnormal (54%) in children with gastrointestinal than in those with respiratory symptoms (35%, p < 0.001). A significant increase in the indications to EpHM due to respiratory symptoms was observed between 1990-92 (25%) and 2005-07 (63%) (p < 0.001). A strong decrease in abnormal EpHM was observed between 1990-92 (63%) and 2005-07 (19%, p < 0.001) and this decrease was inversely related to the yearly percentage of respiratory indications. Conclusions: Our data show that significant modifications in patients’ age and indication to EpHM have occurred in our institution during the last two decades and that respiratory symptoms are today the most frequent indication to EpHM.