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BSPGHAN Motility Working Group position statement: paediatric multichannel intraluminal pH impedance monitoring—indications, methods and interpretation
  1. Mohamed Mutalib1,
  2. David Rawat2,
  3. Keith Lindley3,
  4. Osvaldo Borrelli3,
  5. Steve Perring4,
  6. Marcus K H Auth5,
  7. Nikhil Thapar3
  8. on behalf of BSPGHAN Motility Working Group
  1. 1Paediatric Gastroenterology Department, Evelina London Children's Hospital, London, UK
  2. 2Paediatric Gastroenterology Department, Royal London Hospital, London, UK
  3. 3Paediatric Gastroenterology Department, Great Ormond Street Hospital, London, UK
  4. 4Department of Medical Physics, Poole Hospital, Poole, UK
  5. 5Department of Paediatric Gastroenterology, Hepatology and Nutrition, Alder Hey Children's NHS Foundation Trust, Liverpool, UK
  1. Correspondence to Dr Mohamed Mutalib, Department of Paediatric Gastroenterology, Evelina London Children's Hospital, St Thomas' Hospital, Westminster Bridge Road, London SE1 7EH, UK; Mohamed.mutalib{at}


Background Combined pH-impedance monitoring has been suggested as the investigation of choice for diagnosing gastro-oesophageal reflux in children. Although it is superior to oesophageal pH monitoring in detecting all types of reflux episodes (acid, weakly acidic and alkaline) with the ability to evaluate symptom association with reflux events, it is still limited by the lack of true paediatric normal value and the high cost involved (equipment and personnel).

Objective To produce a position statement on behalf of the Motility Working Group of the British Society of Paediatric Gastroenterology, Hepatology and Nutrition on the indications and practical application of combined oesophageal pH-impedance monitoring in children.

Methods Up-to-date review of available evidence.

Results This document provides a practical guide to clinician on indications, methods and results interpretation of paediatric multichannel intraluminal impedance pH (MII-pH).

Conclusions MII-pH is increasingly used by paediatricians as the diagnostic tool for assessing gastro-oesophageal reflux disease and symptom association. There is wide variation in paediatric practice and a need for standardised practice.


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  • Contributors The article was written jointly by the Motility Working Group.

  • Competing interests None.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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