Acid and Bile Reflux in Children with Gastroesophageal Reflux Disease

Objective To investigate the role of acid and bile reflux in children with gastroesophageal reflux disease (GERD) and to evaluate the significance of detecting acid and bile reflux in diagnosing GERD in children.Methods Using ambulatory 24 h pH mo-(nitoring) and bilirubin monitoring technique, we simultaneously assessed the changes of intraesophageal pH and bile reflux in 23 subjects (including 11 healthy controls and 12 patients with GERD).Results The time of esophageal acid exposure (pH4) for GERD was significantly greater than that of controls(P0.05). Intraesophageal bile reflux , represented by total percentage time of bilirubin absorbance≥0.14,was greater in children with GERD than that in controls(P0.05).Eighty-five percent of children with GERD simultaneously had acid and bile reflux.Conclusions Both bile reflux and acid reflux are very common in children with GERD and both may play an role in the development of GERD. Simultaneously monitoring intraesophageal acid and bile reflux is very important to diagnose GERD.