Diagnostic Utility of Impedance-pH Monitoring in Refractory Non-erosive Reflux Disease
Journal of Neurogastroenterology and Motility
;
: 497-505, 2014.
Article
in English
| WPRIM
| ID: wpr-50165
ABSTRACT
BACKGROUND/AIMS:
Approximately one-third of non-erosive reflux disease (NERD) patients are refractory to proton pump inhibitors (PPI) and face a therapeutic challenge. Therefore, it is important to differentiate between pathological and non-pathological reflux utilizing multichannel intraluminal impedance-pH (MII-pH) to analyze symptom-reflux association and diagnose true NERD versus hyper-sensitive esophagus (HE) and functional heartburn (FH). Herein, we evaluated the diagnostic yield of MII-pH in refractory NERD and sub-classified it based on quantity and quality of acid/non-acid reflux and reflux-symptom association.METHODS:
Sixty symptomatic NERD patients on twice daily PPI for > 2 months were prospectively evaluated by MII-pH. Distal and proximal refluxes, bolus exposure time (BET), esophageal acid exposure time, symptom index (SI) and symptom association probability (SAP) were measured.RESULTS:
Thirty-two (53%) patients had BET > 1.4% (MII-pH positive-true NERD), while 28 (47%) had BET 80% of symptoms were associated with non-acid reflux. The number of distal refluxes in true NERD versus FH or HE were significantly different, but not between FH and HE.CONCLUSIONS:
Approximately 60% of refractory PPI NERD patients had positive reflux-symptom association, primarily due to non-acid reflux. Nearly half of NERD patients on PPI had normal MII-pH monitoring, sub-divided further into FH and HE equally.
Full text:
Available
Index:
WPRIM (Western Pacific)
Main subject:
Prospective Studies
/
Esophagus
/
Proton Pump Inhibitors
/
Heartburn
Type of study:
Diagnostic study
/
Observational study
Limits:
Humans
Language:
English
Journal:
Journal of Neurogastroenterology and Motility
Year:
2014
Type:
Article
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