Effect of Propofol on Acid Reflux Measured with the Bravo pH Monitoring System

Chawla, Anupama; Girda, Eugenia; Walker, Grace; Benedict, Frances Turcotte; Tempel, Mila; Morganstern, Jeffrey

doi:10.1155/2013/605931

Cited by 8 publications

(11 citation statements)

References 8 publications

(7 reference statements)

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“…Similar to the Bravo probe study, 12 our study found increased acid refluxes per hour and total reflux per hour following placement of the probe. However, we also found a significant change over time in the non-acid refluxes per hour in the no sedation group which was not statistically significant in the anesthesia group, contrary to what we had hypothesized.…”

Section: Discussionsupporting

confidence: 87%

“…12 This study found increased reflux episodes in the period following anesthesia, but evaluated only pH and not impedance. In this study, the attachment of the capsule itself may alter reflux patterns.…”

Section: Introductionmentioning

confidence: 81%

“…12 The authors questioned the role that propofol, NPO status, endoscopy with air insufflation, decreased oral intake and decreased activity played in these differences. There is some literature on the effects of propofol on LES pressures; 13 however, no correlation to reflux has been made.…”

Section: Discussionmentioning

confidence: 99%

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Effects of Anesthesia on Pediatric pH Impedance

Hurtado

Sheiko²,

Gralla³

et al. 2016

J. pediatr. gastroenterol. nutr.

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Objectives Anesthesia can alter gastric and small intestinal motility, but its effect on gastroesophageal reflux (GER) is unclear. We set out to evaluate the effect of anesthesia on pH-multichannel intraluminal Impedance (pH Impedance) evaluation of GER. Methods Retrospective single center analysis of 95 pH Impedance probe studies performed in patients both with anesthesia exposure and esophagogastroduodenoscopy (n=50) and without (n=45). Results Increased acid reflux per hour, non-acid reflux per hour and total reflux per hour was observed in the first 4 hours, both overall and in ≥1 year olds and in both sedation groups. This difference remained for the older children without sedation by multiple regression analysis for non-acid reflux per hour and total reflux per hour. Patients using PPI had more non-acid reflux events per hour and total reflux events per hour regardless of sedation. Conclusions Based on the results of this study, there is no need to eliminate the data collected immediately after placement of the probe in children under 1 year old, but in those ≥1 without sedation, there may be a greater number of reflux events in the first 4 hours. The first 4 hours, therefore, should be carefully evaluated in patients older than 1 year of age. Further study is needed to provide normative data for the first 4 hours versus the later time period, both for those undergoing sedation as well as unsedated patients, in order to validate the findings from this study and to better understand the mechanism of GER.

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Section: Discussionsupporting

confidence: 87%

Section: Introductionmentioning

confidence: 81%

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Effects of Anesthesia on Pediatric pH Impedance

Hurtado

Sheiko²,

Gralla³

et al. 2016

J. pediatr. gastroenterol. nutr.

View full text Add to dashboard Cite

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“…Potential disadvantages include additional expense due to endoscopic placement (as na-sal passage can be difficult due to size of capsule), early detachment in a minority of patients, patient discomfort which could require removal via repeat endoscopy, as well as overdiagnosis of GERD due to ingestion of acidic foods [16] . There is also some data suggesting an increased number of reflux episodes during the first 6 hour period following propofol administration [17] .…”

Section: Ambulatory Ph Monitoringmentioning

confidence: 99%

Diagnosis and treatment of gastroesophageal reflux disease

Badillo

Francis

2014

WJGPT

185

124

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Gastroesophageal reflux disease (GERD) is a common disease with a prevalence as high as 10%-20% in the western world. The disease can manifest in various symptoms which can be grouped into typical, atypical and extra-esophageal symptoms. Those with the highest specificity for GERD are acid regurgitation and heartburn. In the absence of alarm symptoms, these symptoms can allow one to make a presumptive diagnosis and initiate empiric therapy. In certain situations, further diagnostic testing is needed to confirm the diagnosis as well as to assess for complications or alternate causes for the symptoms. GERD complications include erosive esophagitis, peptic stricture, Barrett's esophagus, esophageal adenocarcinoma and pulmonary disease. Management of GERD may involve lifestyle modification, medical therapy and surgical therapy. Lifestyle modifications including weight loss and/or head of bed elevation have been shown to improve esophageal pH and/or GERD symptoms. Medical therapy involves acid suppression which can be achieved with antacids, histamine-receptor antagonists or proton-pump inhibitors. Whereas most patients can be effectively managed with medical therapy, others may go on to require anti-reflux surgery after undergoing a proper pre-operative evaluation. The purpose of this review is to discuss the current approach to the diagnosis and treatment of gastroesophageal reflux disease.

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“…Potential disadvantages include additional expense due to endoscopic placement (as nasal passage can be difficult due to size of capsule), early detachment in a minority of patients, patient discomfort which could require removal via repeat endoscopy, as well as overdiagnosis of GERD due to ingestion of acidic foods [16] . There is also some data suggesting an increased number of reflux episodes during the first 6 hour period following propofol administration [17] . Transnasal catheter pH testing is limited by patient tolerance and 24 h monitoring but has the unique advantage of adding impedance which allows distinguishing between acid and non-acid (weakly acidic or weakly alkaline) gastroesophageal reflux.…”

Section: Ambulatory Ph Monitoringmentioning

confidence: 99%

Diagnosis and Treatment of Gastroesophageal Reflux Disease

Vaezi¹

2016

View full text Add to dashboard Cite

Gastroesophageal reflux disease (GERD) is a common disease with a prevalence as high as 10%-20% in the western world. The disease can manifest in various symptoms which can be grouped into typical, atypical and extra-esophageal symptoms. Those with the highest specificity for GERD are acid regurgitation and heartburn. In the absence of alarm symptoms, these symptoms can allow one to make a presumptive diagnosis and initiate empiric therapy. In certain situations, further diagnostic testing is needed to confirm the diagnosis as well as to assess for complications or alternate causes for the symptoms. GERD complications include erosive esophagitis, peptic stricture, Barrett's esophagus, esophageal adenocarcinoma and pulmonary disease. Management of GERD may involve lifestyle modification, medical therapy and surgical therapy. Lifestyle modifications including weight loss and/or head of bed elevation have been shown to improve esophageal pH and/or GERD symptoms. Medical therapy involves acid suppression which can be achieved with antacids, histamine-receptor antagonists or proton-pump inhibitors. Whereas most patients can be effectively managed with medical therapy, others may go on to require antireflux surgery after undergoing a proper pre-operative evaluation. The purpose of this review is to discuss the current approach to the diagnosis and treatment of gastroesophageal reflux disease.

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Effect of Propofol on Acid Reflux Measured with the Bravo pH Monitoring System

Cited by 8 publications

References 8 publications

Effects of Anesthesia on Pediatric pH Impedance

Effects of Anesthesia on Pediatric pH Impedance

Diagnosis and treatment of gastroesophageal reflux disease

Diagnosis and Treatment of Gastroesophageal Reflux Disease

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