Diagnostic Modalities for Gastro-Esophageal Reflux in Infantile Wheezers

OBJECTIVE: To compare the diagnostic value of Gastro-intestinal (GI) scintiscan with 24-h pH study in detecting gastro-esophageal reflux (GER) among infantile wheezers. SUBJECTS: Fifty-two children < 2 years of age. METHODS: All patients, irrespective of symptom underwent study to evaluate for GER. RESULTS: GER studies were positive in almost 45% of cases. The agreement between positivity of these two tests is best among children between 7 and 12 months of age (κ = 0.591, p = 0.002). Overall GI scintiscan was a better test with higher sensitivity and specificity as compared to 24-h pH study when compared with the history suggestive of reflux and clinical response with anti-reflux treatment as standard (p ≤ .001). CONCLUSION: Both GER scan and 24-h pH study are complimentary to each other, however, if both the tests are available then GI scintiscan is better as a single test for GER in these early wheezers.