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2011 | 83 | 9 | 488-496
Article title

Combined Esophageal Multichannel Intraluminal Impedance and pH Monitoring (MII -pH) in the Diagnostics and Treatment of Gastroesophageal Reflux Disease and its Complications

Content
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EN
Abstracts
EN
The technique of 24-hour esophageal multichannel intraluminal impedance monitoring combined with pH-metry (MII-pH) is currently considered to be the golden standard in the diagnostics of gastroesophageal reflux disease (GERD). The technique allows for differentiation of gas and liquid reflux as well as detection of non-acid reflux, which cannot be detected with other techniques that are based only on measuring the pH of gastric contents.The aim of the study was to assess the usefulness of MII-pH in the diagnostics and treatment of GERD and its complications.Material and methods. A group of 213 patients referred to II Katedra i Klinika Chirurgii Ogólnej, Gastroenterologicznej i Nowotworów Układu Pokarmowego Uniwersytetu Medycznego w Lublinie [the Second Faculty and Clinic of General and Gastrointestinal Surgery and Gastrointestinal Oncology at Medical University of Lublin] due to persistent symptoms of GERD and 21 volunteers without any clinical evidence of GERD underwent esophageal monitoring via MII-pH. The results were correlated with those of upper gastrointestinal tract endoscopy. The data gathered during MII-pH and endoscopy as well as information from questionnaires were entered into an MS Excel spreadsheet and subsequently analyzed with STATISTICA PL software.Results and conclusions. MII-pH proved to be considerably more useful than conventional pHmetry in recording acid reflux. The sensitivity of pH-metry based on the MII-pH technique was established at 74%. GERD-induced changes in the esophageal mucosa result in decreased impedance baseline. The presence and severity of inflammatory esophageal lesions was proven to be associated with acid reflux episodes and proximal reflux episodes. No direct relationship between the grade of GERD and the occurrence of non-acid reflux episodes was confirmed. Non-acid reflux episodes were shown to predispose to non-erosive reflux disease (NERD). The results of this study confirm that MIIpH is an essential technique in the diagnostics, as well as in assessment of the course of treatment and the severity of GERD.
Publisher

Year
Volume
83
Issue
9
Pages
488-496
Physical description
Dates
published
1 - 9 - 2011
online
5 - 10 - 2011
Contributors
  • The Second Faculty and Clinic of General and Gastrointestinal Surgery and Gastrointestinal Oncology, Medical University in Lublin
  • The Second Faculty and Clinic of General and Gastrointestinal Surgery and Gastrointestinal Oncology, Medical University in Lublin
author
  • Facio-Maxillary Surgery Clinic, Medical University in Lublin
  • The Second Faculty and Clinic of General and Gastrointestinal Surgery and Gastrointestinal Oncology, Medical University in Lublin
  • The Second Faculty and Clinic of General and Gastrointestinal Surgery and Gastrointestinal Oncology, Medical University in Lublin
References
  • Silny J: Intraluminal multiple electric impedance procedure for measurement of gastrointestinal motility. J Gastointest Mot 1991; 3: 151-62.
  • Park W, Vaezi MF: Esophageal impedance recording: clinical utility and limitations. Curr Gastroenterol Rep 2005; 7: 182-89.[PubMed][Crossref]
  • Sifrim D, Castell D, Dent J et al.: Gastro-oesophageal reflux monitoring: review and consensus report on detection and definitions of acid, non-acid, and gas reflux: Gut 2004; 53: 1024-31.[Crossref]
  • Wytyczne Polskiego Towarzystwa Gastroenterologii: choroba refluksowa przełyku; zmodyfikowane i zaakceptowane na posiedzeniu Zarządu Głównego PTG-E w Warszawie, w dniu 10.06.2005 r. Gastroenterol Pol 2005; 12: 313-19.
  • Dent J, Brun J, Fendrick A: An evidence based of reflux disease management - the Genval Workshop Report. Gut 1999; 44: 1-16.[Crossref]
  • Falk GW: Rozpoznanie i nadzór w przełyku Barretta. W: Ginsberg GG, Kochman ML, Norton I i wsp.: Kliniczna endoskopia przewodu pokarmowego. Tom II. Medipage, Warszawa 2009.
  • Shay S, Tutuian R, Sifrim D et al.: Twenty-four hour ambulatory simultaneous impedance and pH monitoring: a multicenter report of normal values from 60 healthy volunteers. Am J Gastroenterol 2004; 99: 1037-43.[Crossref]
  • Masiak Wioletta: Ocena przydatności badania impedancji przełykowej połączonej z ph-metrią w diagnostyce i terapii choroby refluksowej oraz jej powikłań. Rozprawa doktorska. Uniwersytet Medyczny w Lublinie 2011.
  • Pohl D, Tutuian R: Reflux monitoring: pH-metry, Bilitec and oesophageal impedance measurements. Clinical Gastroenterology 2009; 23: 299-311.[WoS]
  • DeMeester T, Johnson LF, Joseph G et al.: Patterns of gastroesophageal reflux in health and disease. Ann Surg 1976; 184: 459-70.[Crossref]
  • Dodds WJ, Dent J, Hogan WJ et al.: Mechanisms of gastroesophageal reflux in patients with reflux esophagitis. N Engl J Med 1982; 307: 1547-1552.[Crossref]
  • Weusten BL, Akkermans LM, van Berge Henegouwen GP i wsp.: Dynamic characteristic of gastrooesophageal reflux in ambulatory patients with gastrooesophageal reflux disease and normal control subjects. Scan J Gastroenterol 1995; 30: 731-37.[Crossref]
  • Dickman R, Fass R: Ambulatory Esophageal pH Monitoring: New Directions. Dig Dis 2006; 24: 313-18.[Crossref][PubMed]
  • Argewal A, Castell D: Reflux Reduction Therapy. When PPI's Are not Enough. Practical Gastroenterology 2006; 1: 68-72.
  • Maine I, Tutuian R, Castell DO: Symptoms on PPI Therapy Associated with nonacid, acid or no refluks. ACG Presentation; October 2004.
  • Gruebel C, Linke G, Tutuian R et al.: Prospective Study Examining the Impact of Multichannel Intraluminal Impedance on Antireflux Surgery. Surgical Endoscopy 2008; 22: 1241-47.[WoS][Crossref]
  • Wallner G, Solecki M, Tarnowski W: Gastroesophageal reflux disease - clinical practice guidelines. (Choroba refluksowa przełyku - zalecenia dla praktyki klinicznej.) Videosurgery and Other Miniinvasive Techniques 2009; 4(1): 53-61.
  • Wallner G, Masiak W, Pedowski T i wsp.: Diagnostyka i terapia choroby refluksowej przełyku. Terapia 2011; 2: 27-35.
  • Sifrim D, Dupont L, Blondeau K et al.: Weakly acidic reflux in patients with chronic unexplained cough during 24-hour pressure, pH, and impedance monitoring. Gut 2005; 54: 449-54.
  • Waśko-Czopnik D, Blonski W, Paradowski L: Diagnostic difficulties during combined multichannel intraluminal impedance and pH monitoring in patients with esophagitis or Barret's esophagus. Adv Med Sci 2007; 52: 196-98.
  • Shay S: Esophageal impedance monitoring: the ups and downs of a new test. Am J Gastroenterol 2004; 99: 1020-22.[PubMed][Crossref]
  • Zentilin P, Dulbecco P, Savarino E et al.: Combined multichannel intraluminal impedance and pH-metry: a novel technique to improve detection of gastrooesophageal reflux. Literature review. Dig Liv Dis 2004; 36: 565-59.[Crossref]
  • Kahrilas P: Anatomy, and physiology of the gastroesophageal junction. Gastroenterol Clin North Am 1997; 26: 467-86.[Crossref][PubMed]
  • Sifrim D, Holloway R, Silny J: Composition of the Postprandial Refluxate In Patients With Gastroesophageal Reflux Disease. Am J Gastroenterol 2001; 96: 647-55.[Crossref][WoS][PubMed]
Document Type
Publication order reference
Identifiers
YADDA identifier
bwmeta1.element.-psjd-doi-10_2478_v10035-011-0076-7
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