475 ESOPHAGEAL LENGTHS IN CHILDREN CORRELATE WITH HEIGHT: APPLICATION TO THE TUTTLE TEST WITHOUT PRIOR ESOPHAGEAL MANOMETRY

Abstract

The Tuttle test in adults is highly sensitive in detecting gastroesophageal reflux (GER). A modification of this test as applied to children has been described.^* To facilitate a more widespread application of this test in identifying GER, we undertook a two part study. Initially, 119 children, ages 3 weeks to 235 months, had esophageal length (EL) measured at manometric studies. EL was defined as the distance in cm from the lips or the nares to the pressure inversion point of the lower esophageal sphincter (LES). Correlation coefficients with body height (HT) in cm were 0.967 and 0.926 for respective oral and nares determinations, with regression equations of EL=6.7+0.226(HT) and EL= 5+0.252(HT). T test gave 95% within ±3.1 cm (oral) or ±4.1 cm (nares). Subsequently, 20 patients, ages 1 to 180 months, had manometrics and Tuttle tests. The pH probe was placed at 87% of EL - 3.1 or 4.1 cm, as appropriate. In all cases, this placement for the Tuttle test was higher above the LES than the usual procedure.^* 8 patients had a positive test for GER using this method. In the remaining 12 with a negative study, repeating the test by the usual technique^* reconfirmed a negative study in all 12. This data confirms a highly significant correlation between EL and HT and substantiates the feasibility of documenting GER by Tuttle test without prior manometry.

^*Euler, AR and Ament, ME: Pediatrics 60:65-68, 1977.

Log in or create a free account to read this content

Gain free access to this article, as well as selected content from this journal and more on nature.com

Access through your institution

or

Sign in or create an account

Continue with Google

Continue with ORCiD