Ambulatory 24-Hour pH-Metry in the Diagnosis of Gastroesophageal Reflux Disease

Masclee, A.A.M.; Best, Andrea; Graaf, Robin de; Cluysenaer, O. J. J.; Jansen, J. B. M. J.

doi:10.1080/00365521.1990.12067095

Cited by 132 publications

(81 citation statements)

References 23 publications

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“…18,19 Acid reflux time is significantly correlated with the severity of endoscopic esophagitis. 20 In addition, pepsin and bile acids are noxious to the esophageal mucosa, but their injurious action is highly dependent on the presence of acid. Motor dysfunction of the LES and, possibly, the proximal stomach is a major cause of increases in the number of reflux episodes.…”

Section: Gastroesophageal Reflux Diseasementioning

confidence: 99%

Acupuncture for functional gastrointestinal disorders

2006

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Functional gastrointestinal (GI) symptoms are common in the general population. Especially, motor dysfunction of the GI tract and visceral hypersensitivity are important. Acupuncture has been used to treat GI symptoms in China for thousands of years. It is conceivable that acupuncture may be effective in patients with functional GI disorders because it has been shown to alter acid secretion, GI motility, and visceral pain. Acupuncture at the lower limbs (ST-36) causes muscle contractions via the somatoparasympathetic pathway, while at the upper abdomen (CV-12) it causes muscle relaxation via the somatosympathetic pathway. In some patients with gastroesophageal reflux disease (GERD) and functional dyspepsia (FD), peristalsis and gastric motility are impaired. The stimulatory effects of acupuncture at ST-36 on GI motility may be beneficial to patients with GERD or FD, as well as to those with constipation-predominant irritable bowel syndrome (IBS), who show delayed colonic transit. In contrast, the inhibitory effects of acupuncture at CV-12 on GI motility may be beneficial to patients with diarrhea-predominant IBS, because enhanced colonic motility and accelerated colonic transit are reported in such patients. Acupuncture at CV-12 may inhibit gastric acid secretion via the somatosympathetic pathway. Thus, acupuncture may be beneficial to GERD patients. The antiemetic effects of acupuncture at PC-6 (wrist) may be beneficial to patients with FD, whereas the antinociceptive effects of acupuncture at PC-6 and ST-36 may be beneficial to patients with visceral hypersensitivity. In the future, it is expected that acupuncture will be used in the treatment of patients with functional GI disorders.

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Section: Gastroesophageal Reflux Diseasementioning

confidence: 99%

Acupuncture for functional gastrointestinal disorders

2006

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“…The severity of refl ux-associated erosive esophagitis is thought to be directly related to LES pressure and the degree of acid exposure. 5,6 In contrast, currently, no mechanisms determining the severity of symptoms are considered defi nitive. In general, the levels of esophageal acid exposure are lower in patients with NERD than in those with refl ux esophagitis, 1,5 and the response to proton pump inhibitors (the most common treatment for GERD) for symptom relief is signifi cantly inferior in patients with NERD than in those with erosive esophagitis.…”

Section: Introductionmentioning

confidence: 96%

“…5,6 In contrast, currently, no mechanisms determining the severity of symptoms are considered defi nitive. In general, the levels of esophageal acid exposure are lower in patients with NERD than in those with refl ux esophagitis, 1,5 and the response to proton pump inhibitors (the most common treatment for GERD) for symptom relief is signifi cantly inferior in patients with NERD than in those with erosive esophagitis. 7,8 Moreover, there is no correlation between the severity of symptoms and either the presence or grade of esophageal mucosal breaks.…”

Section: Introductionmentioning

confidence: 96%

Impaired gastric motility and its relationship to reflux symptoms in patients with nonerosive gastroesophageal reflux disease

et al. 2009

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“…For example, with PGER defined as a reflux index greater than 4%, 24-hour CAEpHM in symptomatic adults had a sensitivity of 81% and a specificity of 85%. 49 However, with PGER defined as a reflux index greater than 5%, 24-hour CAEpHM in several other groups of symptom¬ atic adult patients had sensitivities of 75% to 100% and speci¬ ficities of 75% to 100%, and diagnoses of PGER based on 24-hour CAEpHM data agreed with those based on clear clinical symptoms or the results of esophageal endoscopy in 89% to 100% of patients examined. 30,41,51,53 The sensitivity and specificity of CAEpHM in adults gen¬ erally increase with its duration (Table 1).…”

Section: Effectiveness Of Caephm In the Diagnosis Of Pger In Adultsmentioning

confidence: 88%

Continuous Ambulatory Esophageal pH Monitoring in the Evaluation of Patients With Gastroesophageal Reflux

Glade¹

1995

JAMA

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Objective.\p=m-\Toprovide clinicians with a technology assessment of the safety and effectiveness of continuous ambulatory esophageal pH monitoring (CAEpHM) in the diagnosis of pathologic gastroesophageal reflux in adults.Participants.\p=m-\Aliterature review and a Diagnostic and Therapeutic Technology Assessment (DATTA) survey questionnaire were mailed to 118 physicians with special interest in gastroesophageal reflux, esophageal disease, or the use of CAEpHM in the diagnosis of noncardiac chest pain. These panelists had been nominated to the DATTA panel by appropriate specialty societies and medical schools. A total of 93 panelists (79%) responded.Evidence.\p=m-\Assessmentwas based on the expert opinion of the panelists, as well as on published scientific and medical literature (available as of June 1, 1994). Published studies were identified by a MEDLINE search using the terms esophagitis, reflux, and gastroesophageal reflux and by review of the references cited in these primary sources.Consensus Process.\p=m-\The respondents completed a DATTA survey questionnaire; the survey results were tabulated, analyzed, and interpreted by an American Medical Association medical scientist.

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Ambulatory 24-Hour pH-Metry in the Diagnosis of Gastroesophageal Reflux Disease

Cited by 132 publications

References 23 publications

Acupuncture for functional gastrointestinal disorders

Acupuncture for functional gastrointestinal disorders

Impaired gastric motility and its relationship to reflux symptoms in patients with nonerosive gastroesophageal reflux disease

Continuous Ambulatory Esophageal pH Monitoring in the Evaluation of Patients With Gastroesophageal Reflux

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