LAUSR

It is now over 20 years since the introduction of multichannel intraluminal impedance monitoring (MII) in the oesophagus.1 Its application in children subsequently followed with the widespread availability of paediatric catheters in 2002. MII detects oesophageal bolus movement by measurement of changes in electrical resistance and is used for assessment of reflux in tandem with pH monitoring (MII-pH). MII-pH heralded an advance in our ability to characterise reflux compared with the previous gold standard, pH monitoring alone. Advantages include the ability to detect nonacid and weakly acid reflux, distinguish between antegrade and retrograde bolus movements, differentiate liquid from gas reflux and assess proximal extent of the refluxate. In the intervening period, the translation of this more sophisticated and accurate measurement into improved patient outcomes has, however, not been as demonstrable as would have been hoped for. The BSPGHAN position statement on MII-pH testing, published in the current issue of the journal, highlights the current state of the technology, practical advice for performance of investigations, as well as many issues and controversies that pertain to the use of the technology in the …