Comprehensive Assessment of Reflux Burden and Mucosal Integrity in Children: Insights from MNBI and Impedance–pH Monitoring
Year: 2025
Type: article
Study design: Observational Study
Abstract: BACKGROUND: Pediatric 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. METHODS: We 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. RESULTS: < 0.0001). In infants, MNBI poorly discriminated pathological acid exposure. In older children, MNBI showed better performance, with optimal cut-offs of ~2525 Ω (Z6) and 3079 Ω (Z5) yielding specificities > 85%. CONCLUSIONS: MNBI 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.
Source: Children
Authors: Felicia Galos, Alexandra Ilie, Mihai Daniel Luca Mirea, Raluca Teodora Radulescu, Mara Ioana Ionescu
Language: English
Subfield: Gastroenterology
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $2,896
OpenAlex ID: W4415815786