Diagnostic Efficacy of 24-hr Esophageal pH Monitoring in Patients with Refractory Gastroesophageal Reflux Disease

Abstract

BACKGROUND:Gastric reflux is one of the most important causes of the referral of patients to the internal clinic, which in some cases causes problems for patients due to resistance to common treatments. Therefore, timely diagnosis and treatment of this group of patients are very important.AIM:The purpose of the present study was to determine the off-proton pump inhibitor (off-PPI) 24 h pH-impedance analyses in patients with refractory gastroesophageal reflux disease (GERD) attending to Taleghani Hospital since 2009 to 2017.METHODS:In this observational descriptive-comparative off-PPI study, 572 patients with refractory GERD who were referred to Taleghani Hospital in Tehran from 2009 to 2017 were selected, and the results of 24 h pH Impedance analysis were then assessed.RESULTS:The results of 24h pH-impedance indicated that 7% of cases belonged to Pure Acid Reflux followed by weakly Acid (1%), non-acid (0.3%), mixed & gas (5.2%), functional (58.4%) and oesophagal hypersensitivity (28%). Furthermore, weakly acid plus acid was also found to be 8% and Weakly Acid + Acid + Non-Acid were determined as 8.3%.CONCLUSIONS:Our findings suggested that nearly more than half of the patients with refractory GERD would have a functional disorder in the 24h pH-impedance analysis.

Evidence-Based Practice Guideline for Surgical Treatment of Gastroesophageal Reflux Disease 2018

“…An objective diagnosis of GERD before surgery is essential [535455]. The purpose of the preoperative examination is to select patients who will benefit from surgical treatment.…”

“…Another important diagnostic tool is 24-hour pH monitoring [666768]. Due to the lack of evidence of GERD in EGD, 24-hour pH monitoring is required to distinguish between acid reflux and non-acid reflux [556970]. It is also an important predictive factor of prognosis after surgical treatment [7172].…”

Gold nanoparticles and hepatitis B virus

“…As such there is a pertinent need to devise a simple, fast but yet more efficient technique for the diagnosis of HBV [6]. In the past few decades, there has been an increasing number of the application of biosensors in detecting various pathogens including hepatitis virus [7]. According to it working principle, biosensors are highly sensitive analytical devices made up of a biological element for detection or recognition of a specific analyte based on its inherent physicochemical characteristics and an electronic or optical transducer for signal transmission and measurement [8,9].…”

Gold nanoparticles and hepatitis B virus

“…As such there is a pertinent need to devise a simple, fast but yet more efficient technique for the diagnosis of HBV [6]. In the past few decades, there has been an increasing number of the application of biosensors in detecting various pathogens including hepatitis virus [7]. According to it working principle, biosensors are highly sensitive analytical devices made up of a biological element for detection or recognition of a specific analyte based on it inherent physicochemical characteristics and an electronic or optical transducer for signal transmission and measurement [8,9].…”