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Alkaline gastroesophageal reflux (AGER) has been documented in adult subjects, but few in pediatrics. 24-hours double pH-monitoring was performed in 40 nonrefluxers (control group) and 69 gastroesophageal reflux (RGE) children to quantify AGER. Esophageal phmetric variables were measured at 4 and 7 levels; gastric variables were measured at 4. Forty cases were classified into acid GER, 15 into acid alkaline GER (mixed), 8 into AGER, and 6, with clinical, manometric or endoscopic evidence of GER into "silent" GER. The acid and mixed GER groups had longer periods of acid exposure in esophagus than control, AGER and "silent" GER groups. All groups had long periods of pH > 7 in esophagus. In conclusion, the double gastroesophageal pH monitoring, by verifying the source of alkaline reflux into the esophagus had advantage of better quantifying alkaline reflux over single pH monitoring. AGER might be more frequent in pediatrics than adults.
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