The Role of Shorter Than 24-H pH Monitoring Periods in the Diagnosis of Gastro-Oesophageal Reflux

Rokkas, Theodore; Anggiansah, Angela; Uzoechina, E; Owen, William J.; Sladen, G E

doi:10.3109/00365528609003108

Cited by 21 publications

(8 citation statements)

References 8 publications

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“…In most previous investigations of reflux patterns, oesophageal motor activity was evaluated by means of short term manometry carried out before pH monitoring and without knowledge of actual intra-oesophageal pH at the time of measurement.3'7 8 17 18 Frequent contractions during intervals of normal pH may contribute to frequent relaxation of the gastro-oesophageal sphincter. The high pressure activity during normal pH seen in the patient groups may therefore, to some extent, explain why they had frequent episodes of reflux as well as prolonged reflux.…”

Section: Resultsmentioning

confidence: 99%

Reflux patterns and related oesophageal motor activity in gastro-oesophageal reflux disease.

Kruse-Andersen

Wallin

Madsén

1990

Gut

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Simultaneous intraoesophageal pH and pressure monitoring were performed for 12 hours in 20 patients with abnormal acid gastrooesophageal reflux or oesophagitis and in 10 healthy volunteers to determine characteristic reflux patterns with time. Increased acid exposure was not the only factor that characterised patients with oesophagitis. Indeed an overlap existed between patients with and without oesophagitis regarding total acid exposure time. Patients with oesophagitis suffered reflux nearly as much at night and in the morning as during the postprandial period. They also had as much reflux as a result of small and slow changes in pH around the pH limit of 4 as they had due to proper reflux episodes. This did not change over time after the postprandial period. More 12 hour acid exposure was related to more frequent night time reflux. In normal subjects compared with patients reflux triggered increased contractile activity, and contractile activity at a normal pH was greater in patients than in normal subjects.

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Section: Resultsmentioning

confidence: 99%

Reflux patterns and related oesophageal motor activity in gastro-oesophageal reflux disease.

Kruse-Andersen

Wallin

Madsén

1990

Gut

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“…In addition, 3‐hour recording is likely to be better tolerated, compared to longer duration recording, even if ambulatory. In fact, the number of acidic reflux events as well as acid exposure for 3‐hour post‐prandial recording using standardized test meals, has been shown to correlate with results obtained at 24‐hour recording . However, shorter duration of recording increases intra‐individual variations …”

Section: Discussionmentioning

confidence: 99%

“…In fact, the number of acidic reflux events as well as acid exposure for 3-hour post-prandial recording using standardized test meals, has been shown to correlate with results obtained at 24-hour recording. [7][8][9] However, shorter duration of recording increases intra-individual variations. 6 In the present work, using 24-hour recording as a gold standard, we showed, that shorter duration of esophageal multichannel intraluminal impedance (e.g.…”

Section: Discussionmentioning

confidence: 99%

“…However, to our knowledge, this has not yet been demonstrated with multichannel intraluminal impedance recording. In fact, it was previously reported that data from a 3‐hour pH recording were correlated to the data obtained from a 24‐hour recording . Therefore, we postulated that esophageal multichannel intraluminal impedance recording obtained over 3 hours could lead to relevant information for diagnosing or excluding gastroesophageal reflux disease.…”

Section: Introductionmentioning

confidence: 85%

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Can multichannel intraluminal pH-impedance monitoring be limited to 3 hours? Comparison between ambulatory 24-hour and post-prandial 3-hour recording

et al. 2013

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Esophageal multichannel intraluminal pH-impedance recording (MII) is now a valid technique for determining the acidic, liquid, gas or mixed nature of gastroesophageal reflux episodes. However, some recordings may stop prematurely due to technical reasons or poor patient tolerance of the probe. Therefore, we questioned whether analysis of post-prandial 3-hour recording could predict the results obtained in ambulatory 24-hour recording. Fifty patients with symptoms of gastroesophageal reflux disease were investigated. For each patient, post-prandial 3-hour MII was recorded after a test meal, then followed by ambulatory 21-hour MII. Correlation between the total number of liquid reflux events in the 3-hour and 24-hour recordings was elevated (R=0.71; P<0.001), with better correlation for acid (R=0.80; P<0.001) and weak acid reflux (R=0.56; P<0.001) than non-acid reflux (R=0.44; P<0.01). Sensitivity and specificity of 3-hour recording in detecting elevated liquid reflux over 24 hours (id>75reflux/24 h) were 49% and 100%, respectively, for 8 or less liquid/mixed reflux events per 3 hours, and 78% and 88%, respectively for 15 or more liquid/mixed reflux events per 3 hours. The sensitivity and specificity of symptom association probability (SAP) calculated over 3 hours were 56% and 91%, respectively. In conclusion, we identified relevant indicators on the 3-hour post-prandial recording likely to give accurate prediction of absence or presence of gastroesophageal reflux disease from 24-hour MII recording.

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“…Some investigators, for example, have revealed that the development of esophagitis is related to increased supine reflux [5,24,[28][29][30] . Others have found evidence to support the opinion that daytime gastroesophageal reflux plays a more important role in the development of esophagitis [31][32][33][34] . Although there are different opinions as to the relationship between patterns of GER and esophagitis, it is generally recognised that a difference in patterns of GER is related to the development of esophagitis.…”

Section: Re Pr Phr Phrementioning

confidence: 95%

Study of the influence of hiatus hernia on gastroesophageal reflux

Zhu¹

2011

WJG

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AIM:To explore whether the presence of a sliding hiatus hernia influences gastroesophageal reflux. METHODS:Endoscopy and 24 h pH monitoring were performed for 197 outpatients with gastroesophageal reflux symptoms. RESULTS:Of the 1�7 patients with symptoms of gastroesophageal reflux, patients with hiatus hernia accounted for 36%. The incidence of esophagitis in patients with hiatus hernia was signi��cantly higher than that in patients without hiatus hernia. The results of 24 h pH monitoring showed that 84 patients had physiological reflux, 37 had pathological reflux without esophagitis, 64 had reflux esophagitis and 12 had physiological reflux concomitant with esophagitis. All the patients with hiatus hernia had a longer percentage time with supine reflux and a higher fre�uency of episodes lasting over 5 min at night compared to those without hiatus hernia. The incidence of combined daytime and nocturnal reflux in patients with hiatus hernia was signi��cantly higher than that in patients without hiatus hernia. CONCLUSION:Pathological reflux and reflux esophagitis in some patients with symptoms of gastroesophageal reflux represent two different stages of gastroesophageal reflux disease. Pathological reflux is the first stage, in which the lower esophageal sphincter is incompetent but the esophageal mucosal resistance effectively prevents regurgitated acid from damaging the esophageal mucosa. Reflux esophagitis represents the second stage, in which the aggression of the regurgitated acid is so strong that the esophageal mucosa fails to resist it and the epithelium of the esophagus is damaged. Patients with hiatus hernia have a high incidence of combined daytime and nocturnal reflux, with the latter being responsible for esophagitis.

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The Role of Shorter Than 24-H pH Monitoring Periods in the Diagnosis of Gastro-Oesophageal Reflux

Cited by 21 publications

References 8 publications

Reflux patterns and related oesophageal motor activity in gastro-oesophageal reflux disease.

Reflux patterns and related oesophageal motor activity in gastro-oesophageal reflux disease.

Can multichannel intraluminal pH-impedance monitoring be limited to 3 hours? Comparison between ambulatory 24-hour and post-prandial 3-hour recording

Study of the influence of hiatus hernia on gastroesophageal reflux

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