Prolonged, wireless pH-studies have a high diagnostic yield in patients with reflux symptoms and negative 24-h catheter-based pH-studies.
Neurogastroenterol Motil
; 23(5): 419-26, 2011 May.
Article
en En
| MEDLINE
| ID: mdl-21235685
BACKGROUND: Catheter-based esophageal pH-monitoring is used to evaluate patients with suspected gastro-esophageal reflux disease (GERD); however false-negative results may occur due to poor tolerance of the catheter with reduced oral intake and activity, or high day-to-day variation in reflux and symptom events. We assessed diagnostic yield and clinical impact of prolonged, wireless pH-monitoring in patients with negative results from 24-h catheter-based studies and ongoing symptoms. METHODS: Esophageal acid exposure (percentage time pH <4), Symptom Index, and Symptom Association Probability (SAP) were calculated. Diagnostic yield was assessed using Average (mean) and Worst Day (24-h period with highest acid exposure or symptom load) analyses. Outcome data were assessed 6-36 months (median 24) after initiation of definitive therapy based on physiologic testing. KEY RESULTS: Data from prolonged pH-monitoring up to 96-h (median 72-h) were available from 38 patients. Using Average and Worst Day analysis, esophageal acid exposure was pathologic in 37% and 47%, whereas SAP was positive in 34% and 63% of patients, respectively. Overall using Average and Worst Day analyses, 61% and 76% patients were diagnosed with GERD based on either pathologic acid exposure or positive symptom association. Of 12 patients that underwent antireflux surgery, 10(83%) reported a good outcome at a median 24 months follow-up. CONCLUSIONS & INFERENCES: Prolonged, wireless pH-monitoring increases test sensitivity and diagnostic yield in patients with continuing esophageal symptoms despite negative 24-h catheter-based pH-studies. Without a definitive diagnosis, many would not have received effective treatment.
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Reflujo Gastroesofágico
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Monitorización del pH Esofágico
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Catéteres
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Concentración de Iones de Hidrógeno
Tipo de estudio:
Diagnostic_studies
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Observational_studies
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Risk_factors_studies
Límite:
Adolescent
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Adult
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Aged
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Revista:
Neurogastroenterol Motil
Asunto de la revista:
GASTROENTEROLOGIA
/
NEUROLOGIA
Año:
2011
Tipo del documento:
Article
Pais de publicación:
Reino Unido