Transmucosal potential difference; diagnostic value in gastro-oseophageal reflux.

Khamis, B; Kennedy, Claire; Finucane, J; Doyle, J. S.

doi:10.1136/gut.19.5.396

Cited by 26 publications

(10 citation statements)

References 10 publications

(12 reference statements)

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“…In the stomach measurements of transmural electrical potential differences have been shown to detect damage to the gastric mucosal barrier [2,4,8,9,10,13,22], which led to the conclusion that maintenance of gastric PD is a sensitive indicator of mucosal integrity [5,6,20]. More recently it has been suggested that, similar to the stomach, transmural potential difference measurements of the esophagus represent an accurate method for the diagnosis of esophageal mucosal damage [17]. More recently it has been suggested that, similar to the stomach, transmural potential difference measurements of the esophagus represent an accurate method for the diagnosis of esophageal mucosal damage [17].…”

Section: Sehliisselwiirter: Gastro6sophagealer Reflux -Potentialdiffementioning

confidence: 99%

Esophageal transmural potential difference in patients with symptomatic gastroesophageal reflux

Eckardt

Adami

1980

Klin Wochenschr

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Esophageal electrical potential difference (PD) was studied in 9 patients with symptomatic gastroesophageal reflux and in 9 healthy control subjects. None of the patients revealed gross mucosal damage by radiography or endoscopy, but all of them showed positive acid perfusion studies. In the stomach and across the lower esophageal sphincter PD profiles were remarkably similar in patients and controls. Throughout the lower esophagus however, PD values were slightly higher in patients with symptomatic reflux than in healthy volunteers. These data are in contrast to a previous investigation, in which patients with reflux-induced gross mucosal damage revealed a decreased PD in the lower esophagus. Thus it is concluded that PD measurements of the lower esophagus do not appear to be a valuable test in the differentiation of chest pain of cardiac and esophageal origin.

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Section: Sehliisselwiirter: Gastro6sophagealer Reflux -Potentialdiffementioning

confidence: 99%

Esophageal transmural potential difference in patients with symptomatic gastroesophageal reflux

Eckardt

Adami

1980

Klin Wochenschr

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“…The measurement of buccal [19. 20], esophageal [21,22], small intestinal [24], colonic [25] and rectal [26] PD was indeed described as both a research and diagnostic tool.…”

Section: Discussionmentioning

confidence: 99%

Simultaneous Measurement and Recording of Gastric Potential Difference and Intragastric pH in Man

Scarpignato

Galmiche

1990

Dig Dis

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Gastric potential difference (GPD) is used increasingly as an index of mucosal integrity. The technique for GPD measurement currently employed is however laborious due to the preparation and check of KCl-agarose bridges prior to each experiment. In addition, calculations – usually handmade – are time-consuming and inaccurate. Therefore, a new apparatus allowing continuous recording of basal and drug-induced changes in GPD values was developed. A commercially available 24-hour pH monitor (Proxima Light®^, Synectics Medical) was modified in order to allow GPD measurement and recording with subsequent elaboration of data. Furthermore, simultaneous measurement of GPD and intragastric pH through the use of a single stomach probe was made possible. The new method was checked towards the classical PD measuring system employing KCl-agarose bridges. The readings obtained with both systems, either in basal conditions or after aspirin, correlated in a highly significant way. Readings proved to be quite stable with a variation, for 150 consecutive values, of less than 2 mV. With this system the effect of pH modifications, obtained through H₂ receptor stimulation and inhibition, on the behaviour of GPD values was investigated in healthy volunteers. Analysis of paired data obtained from these experiments showed an inverse relationship between these two parameters. This suggests that GPD and pH should be measured together, especially during experiments aiming to study drug effects on gastric mucosa. Although the apparatus described was developed for PD measurement and recording in the stomach, it can be used easily for PD measurement across the mucosa of the entire digestive tract, for example in the esophagus, colon or rectum.

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“…Several investigators have measured transmucosal esophageal PD in patients with reflux esophagitis [21][22][23][24][25][26][27], Many of them found less negative PD values in patients with reflux esophagitis compared with healthy subjects, although two studies [22,25] reported higher (i.e. more negative) values (table 1).…”

Section: Esophageal Pd In Esophageal Diseasementioning

confidence: 99%

“…However, more recent studies [21][22][23][24][25][26][27], 52 Scarpignato/Micali/Galmiche Transmucosal Potential Difference asan Index of Esophageal Mucosal Integrity [31], Four years later, the same team [23] reported a further refinement of the technique by introducing the Ringer washout of the esophagus in order to prevent or reduce the interference of junction, diffusion and/or streaming potential (see below).…”

Section: Esophageal Pdmentioning

confidence: 99%

Transmucosal Potential Difference as an Index of Esophageal Mucosal Integrity

Scarpignato

Micali²,

Galmiche³

1995

Digestion

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All the epithelia lining the gastrointestinal (GI) tract, including that of the esophagus, exhibit a transmucosal electrical potential difference (PD). The luminal surface of the GI mucosa is indeed electrically negative when compared with the serosal one. Although it was initially felt that the body of the esophagus exhibits a PD near 0 or slightly positive, recent studies, using parenteral reference electrodes, have shown a negative PD of around -15 mV. Measurement of esophageal PD has been mainly used to locate both the lower and the upper esophageal sphincters but very rarely to evaluate esophageal mucosal integrity in clinical settings, most probably due to the difficulties encountered during measurement of mucosal PD. Reliable techniques to measure esophageal PD simultaneously with esophageal pressure or mucosal pH are now available. Application of these recently developed methodologies showed that measurement of esophageal PD during either manometry or endoscopy provides meaningful information about mucosal integrity. Indeed, tissue injury, either neoplastic or inflammatory, usually results in a less negative PD. In contrast, an abnormally high negative PD is very often observed in patients with columnar-lined lower esophagus. In patients with microscopic reflux esophagitis, PD exhibits less negative values which are significantly correlated with the degree of the mucosal damage. Normalization of the altered PD after either medical or surgical treatment makes it an additional parameter to evaluate the effect of a given therapy.

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Transmucosal potential difference; diagnostic value in gastro-oseophageal reflux.

Cited by 26 publications

References 10 publications

Esophageal transmural potential difference in patients with symptomatic gastroesophageal reflux

Esophageal transmural potential difference in patients with symptomatic gastroesophageal reflux

Simultaneous Measurement and Recording of Gastric Potential Difference and Intragastric pH in Man

Transmucosal Potential Difference as an Index of Esophageal Mucosal Integrity

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