Simple Diagnostic Method of Symptomatic Gastroesophageal Reflux in Neonate

PURPOSE: The aim of this study was to identify usefulness of simple oral and gastric pH measurement using pH paper on detection of symptomatic gastroesophageal reflux in neonates. METHODS: This prospective study included a total of 66 neonates born at Konyang University Hospital from June 2004 to June 2005. Each neonate's oral and gastric pH levels measured with pH paper at 6 hourly intervals. Suspected gastroesophageal refluex neonates were studied 24-hr lower esophageal pH monitoring or upper GI series and confirmed. We compared oral and gastric pH between symptomatic gastroesophageal reflux (GER) group and asymptomatic (control) group. RESULTS: GER group consist of 12 neonates and control group consist of 54 neonates. Oral and gastric pH were 5.4+/-0.6, 2.9+/-0.5 in GER group, 6.0+/-0.3, 3.9+/-0.9 in control group, the differences between two groups were significant (P<0.05). All neonates of GER group were corfirmed gastroesophageal reflux by 24-hr lower esophageal pH monitoring or upper GI series studies. Our data indicate as a predictor for significantly symptomatic gastroesophageal reflux, at oral pH 5.75, has a sensitivity 92%, specificity 89%, positive predictive value of 65%, and negative predictive value of 98%. The difference between oral and gastric pH (oral pH-gastric pH) was not significant in each group. CONCLUSION: In neonates with symptomatic gastroesophageal reflux oral and gastric pH were significantly lower than asymptomatic neonates. Oral and gastric pH were related with clinically significant symptoms of gastroesophageal reflux. We suggest that pH measurement could be a possible simple screening test of symptomatic gastroesophageal reflux.

Measurements of Oral and Gastric pH in Neonates

PURPOSE: The purpose of this study was to measure the oral and gastric pH among preterm and term infants by the simple experimental method using pH paper. METHODS: This prospective study included a total of 60 neonates born at Konyang University Hospital from June 2004 to September 2004. Each neonate's oral and gastric pH levels were measured with pH paper at 6 hourly intervals on the first and the fifth day of life. 15 preterm infants were examined until twenty first day of life. RESULTS: The oral and gastric pH of 60 neonates were 6.3+/-0.5 and 4.1+/-1.0 on the first day and 6.0+/-0.3 and 3.9+/-0.9 on the fifth day, respectively. The preterm infant had lower oral and gastric pH of 6.4+/-0.6 and 4.3+/-1.1 on the first day and 6.0+/-0.2 and 4.2+/-1.0 on the fifth day, respectively in comparison to those of term infant's oral and gastric pH of 6.3+/-0.4, 4.0+/-0.9 on the first day and 6.1+/-0.3 and 3.7+/-0.8 on the fifth day, respectively. The gastric pH's of preterm infant on the first, fifth and twenty first day of life were 4.6+/-1.4, 4.3+/-1.0 and 4.2+/-1.0, respectively. CONCLUSION: This study reports the value of neonates' oral and gastric pH on the first and fifth day of life. The average gastric pH of neonate is higher than that of adult's and preterm infant's gastric pH is higher than term infant's. The gastric pH of preterm infant decreased in time.