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Ph probe and esophagic impedance

C Prakash Gyawali, Nicola de Bortoli, John Clarke, Carla Marinelli, Salvatore Tolone, Sabine Roman, Edoardo Savarino
Esophageal symptoms are common, and can arise from mucosal, motor, functional, and neoplastic processes, among others. Judicious use of diagnostic testing can help define the etiology of symptoms and can direct management. Endoscopy, esophageal high-resolution manometry (HRM), ambulatory pH or pH-impedance manometry, and barium radiography are commonly used for esophageal function testing; functional lumen imaging probe is an emerging option. Recent consensus guidelines have provided direction in using test findings toward defining mechanisms of esophageal symptoms...
May 12, 2018: Annals of the New York Academy of Sciences
M Hollenbach, A Hoffmeister, J Rosendahl, J Mössner
In this review article important and frequently used investigation methods for gastrointestinal functional diagnostics are presented. Some other rarely used special investigations are also explained. The hydrogen breath test is simple to carry out, ubiquitously available and enables the detection of lactose, fructose and sorbitol malabsorption. Furthermore, by the application of glucose, the test can be carried out when there is a suspicion of abnormal intestinal bacterial colonization and using lactulose for measuring small intestinal transit time...
January 2018: Der Internist
D Kim, Y W Min, J G Park, H Lee, B-H Min, J H Lee, P-L Rhee, J J Kim, J I Zo
This study aims to assess the influence of esophagectomy with gastric transposition on the gastroesophageal reflux (GER) and gastric acidity in patients with esophageal cancer. Data on 53 esophageal cancer patients who underwent 24-hour impedance-pH monitoring after esophagectomy were retrospectively analyzed. We used a solid-state esophageal pH probe in which the esophageal pH sensor is placed 1.5 cm distal to the upper esophageal sphincter and the gastric pH sensor is located 15 cm distal to the esophageal pH channel...
December 1, 2017: Diseases of the Esophagus: Official Journal of the International Society for Diseases of the Esophagus
C P Gyawali, S Roman, A J Bredenoord, M Fox, J Keller, J E Pandolfino, D Sifrim, R Tatum, R Yadlapati, E Savarino
BACKGROUND: High-resolution manometry (HRM) has resulted in new revelations regarding the pathophysiology of gastro-esophageal reflux disease (GERD). The impact of new HRM motor paradigms on reflux burden needs further definition, leading to a modern approach to motor testing in GERD. METHODS: Focused literature searches were conducted, evaluating pathophysiology of GERD with emphasis on HRM. The results were discussed with an international group of experts to develop a consensus on the role of HRM in GERD...
December 2017: Neurogastroenterology and Motility: the Official Journal of the European Gastrointestinal Motility Society
Christian Lottrup, Anne L Krarup, Hans Gregersen, Per Ejstrud, Asbjørn M Drewes
Background/Aims: Impaired esophageal acid clearance may be a contributing factor in the pathogenesis of Barrett's esophagus. However, few studies have measured acid clearance as such in these patients. In this explorative, cross-sectional study, we aimed to compare esophageal acid clearance and swallowing rate in patients with Barrett's esophagus to that in healthy controls. Methods: A total of 26 patients with histology-confirmed Barrett's esophagus and 12 healthy controls underwent (1) upper endoscopy, (2) an acid clearance test using a pH-impedance probe under controlled conditions including controlled and random swallowing, and (3) an ambulatory pH-impedance measurement...
October 30, 2016: Journal of Neurogastroenterology and Motility
Anna Górecka-Tuteja, Izabela Jastrzębska, Jacek Składzień, Krzysztof Fyderek
BACKGROUND/AIMS: To evaluate the characteristic properties of laryngopharyngeal reflux (LPR) and gastroesophageal reflux (GER) in children with otitis media with effusion (OME) using 24-hour multichannel intraluminal impedance combined with dual-probe (pharyngeal and esophageal) pH-metry. METHODS: Children aged 7-10 years of age with OME underwent 24-hour multichannel intraluminal impedance pH-metry. The upper pH sensor was situated 1 cm above the upper esophageal sphincter, and the lower pH sensor was placed 3-5 cm above the lower esophageal sphincter...
July 30, 2016: Journal of Neurogastroenterology and Motility
Saowanee Ngamruengphong, Burkhard H A von Rahden, Jörg Filser, Amy Tyberg, Amit Desai, Reem Z Sharaiha, Arnon Lambroza, Vivek Kumbhari, Mohamad El Zein, Ahmed Abdelgelil, Sepideh Besharati, John O Clarke, Ellen M Stein, Anthony N Kalloo, Michel Kahaleh, Mouen A Khashab
BACKGROUND: Peroral endoscopic myotomy (POEM) has been introduced as an endoscopic alternative to surgical myotomy. The endoluminal functional lumen imaging probe (endoFLIP) evaluates esophagogastric junction (EGJ) distensibility based on cross-sectional area and pressure in response to volume distension. The aim of this study was to evaluate whether there is a correlation between endoFLIP measurements during POEM and postoperative clinical outcomes in terms of symptom relief and development of post-procedure reflux...
July 2016: Surgical Endoscopy
Robert J Yawn, Mohammad Fazili, Gwen Provo-Bell, Christopher T Wootten
INTRODUCTION: Bronchoalveolar lavage (BAL)-nucleated cell counts and the lipid-laden alveolar macrophage index (LLMI) have been investigated in predicting chronic aspiration as well as reflux esophagitis with variable results. To date, BAL neutrophil percentages and the LLMI have not been described in patients with eosinophilic esophagitis (EoE). OBJECTIVES: To evaluate BAL neutrophil percentages and LLMI levels in patients with EoE and compare these levels in patients with aerodigestive concerns without biopsy-proven EoE...
November 2015: International Journal of Pediatric Otorhinolaryngology
Yue Qu, Jing-Ying Ye, De-Min Han, Li Zheng, Xin Cao, Yu-Huan Zhang, Xiu Ding
BACKGROUND: Obstructive sleep apnea/hypopnea syndrome (OSAHS) and laryngopharyngeal reflux (LPR) disease have a high comorbidity rate, but the potential causal relation between the two diseases remains unclear. Our objectives were to investigate the esophageal functional changes in OSAHS patients and determine whether OSAHS affects LPR by affecting esophageal functions. METHODS: Thirty-six OSAHS patients and 10 healthy controls underwent 24-h double-probed combined esophageal multichannel intraluminal impedance and pH monitoring simultaneously with polysomnography...
August 20, 2015: Chinese Medical Journal
Erik Person, Christopher Rife, Janice Freeman, Aaron Clark, Donald O Castell
GOAL: We hypothesized that sleeping left-side down with the head/torso elevated reduces recumbent gastroesophageal reflux (GER). BACKGROUND: Previous studies show that sleeping with head of bed elevated or on wedge reduces GER and lying left-side down reduces GER versus right-side down and supine. No prior studies have evaluated the potential compounding effects of lying in an inclined position combined with lateral positioning on GER. STUDY: We evaluated a sleep-positioning device (SPD) consisting of an inclined base and body pillow that maintains lateral position while elevating the head/torso...
September 2015: Journal of Clinical Gastroenterology
G Mazzoleni, C Vailati, D G Lisma, P A Testoni, S Passaretti
BACKGROUND: 24-hour esophageal pH-impedance (pH-MII) is not totally reliable for laryngopharyngeal reflux (LPR). Oropharyngeal (OP) pH-monitoring with the Dx-pH probe may detect LPR better. The correlation between these two techniques is not thoroughly established. Aim of this study is to examine the correlation between OP pH-metry and esophageal pH-MII monitoring. METHODS: Thirty-six consecutive patients with suspected gastroesophageal reflux disease-related extra-esophageal symptoms were evaluated using 24-h OP-pH and concomitant esophageal pH-MII monitoring...
November 2014: Neurogastroenterology and Motility: the Official Journal of the European Gastrointestinal Motility Society
Zhen Gooi, Stacey L Ishman, Jonathan M Bock, Joel H Blumin, Lee M Akst
OBJECTIVE: This study aimed to describe current patterns for diagnosis and treatment of laryngopharyngeal reflux (LPR) and analyze differences between laryngologists and non-laryngologists. METHODS: American Academy of Otolaryngology-Head and Neck Surgery and American Broncho-Esophagological Association members were invited to complete an online survey regarding evaluation, diagnosis, and treatment of LPR. Subgroup analysis was performed to identify differences between respondents who completed laryngology fellowships (LF) and those who did not (NL)...
October 2014: Annals of Otology, Rhinology, and Laryngology
Ikuo Hirano
In eosinophilic esophagitis (EoE), diagnostic tests aid in the identification of pathophysiologic consequences and accurate detection of the disease. The EoE Endoscopic Reference Score (EREFS) classifies and grades the severity of the five major endoscopically identified esophageal features of EoE (edema, rings, exudates, furrows and strictures). The EREFS may be useful in the evaluation of disease severity and as an objective outcome of response to therapy. pH monitoring identifies the presence of abnormal degrees of acid exposure in the esophagus that characterizes gastroesophageal reflux disease...
2014: Digestive Diseases
G Gourcerol, E Verin, A M Leroi, P Ducrotté
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...
November 2014: Diseases of the Esophagus: Official Journal of the International Society for Diseases of the Esophagus
Rachel Rosen, Janine Amirault, Nikki Johnston, Kenan Haver, Umakanth Khatwa, Eitan Rubinstein, Samuel Nurko
BACKGROUND: Gastroesophageal reflux (GER) has been implicated as a causal factor in respiratory disease but prior studies have focused on the role of acid alone in the genesis of symptoms. Prior studies have relied on pH probe testing but this is blind to non-acid reflux which has been implicated in the genesis of extraesophageal symptoms. The objective of this prospective, cross-sectional study is to determine the utility of gastroesophageal reflux testing, including multichannel intraluminal impedance with pH (pH-MII) and upper gastrointestinal endoscopy (EGD), in the child with intractable cough and wheezing...
November 2014: Pediatric Pulmonology
Nicolaas F Rinsma, Fabiënne G Smeets, Daisy W Bruls, Boudewijn F Kessing, Nicole D Bouvy, Ad A M Masclee, José M Conchillo
OBJECTIVES: Transoral incisionless fundoplication (TIF) is a new endoscopic treatment option for gastroesophageal reflux disease (GERD). The mechanisms underlying the anti-reflux effect of this new procedure have not been studied. We therefore conducted this explorative study to evaluate the effect of TIF on reflux mechanisms, focusing on transient lower esophageal sphincter relaxations (TLESRs) and esophagogastric junction (EGJ) distensibility. METHODS: GERD patients (N = 15; 11 males, mean age 41 years, range 23-66), dissatisfied with medical treatment were studied before and 6 months after TIF...
March 2014: Surgical Endoscopy
Edoardo Savarino, Patrizia Zentilin, Vincenzo Savarino, Andrea Tenca, Roberto Penagini, John O Clarke, Ivana Bravi, Frank Zerbib, Elif Saritaş Yüksel
The following paper on functional testing of the pharynx includes commentaries on the use of 24-h pH-impedance testing to identify patients with nonacid reflux and the caveats associated with automatic and visual analysis; the potential diagnostic yield of ambulatory high-resolution manomentry (HRM), particularly in identifying non-cardiac chest pain and transient lower esophageal sphincter relaxations; the differential manometric identification of conditions facilitated by using solid swallows, and the advantages of the newly developed ResTech oropharyngeal pH probe in the detection of proximal reflux events...
October 2013: Annals of the New York Academy of Sciences
Jia-Feng Wu, Wei-Chung Hsu, Ping-Huei Tseng, Hsiu-Po Wang, Hong-Yuan Hsu, Mei-Hwei Chang, Yen-Hsuan Ni
BACKGROUND: The role of combined multichannel intraluminal impedance and pH monitoring (MII-pH) in diagnosing sliding hiatal hernia in gastroesophageal reflux disease (GERD) children remains unclear. We aimed to explore the clinical efficacy of MII-pH as a supplement diagnostic method for sliding hiatal hernia. METHODS: A total of 104 symptomatic GERD children [mean ± standard deviation (SD) age = 4.5 ± 5.5 years] were recruited. All of them were diagnosed as GERD with and without sliding hiatal hernia by barium and/or esophagogastroduodenoscopy study...
November 2013: Journal of Gastroenterology
Hung Cao, Smitha Rao, Shou-jiang Tang, Harry F Tibbals, Stuart Spechler, J-C Chiao
BACKGROUND: Chronic GERD affects approximately 15% of adults in the United States and is one of the most prevalent clinical conditions involving the GI tract. The commercial tools for monitoring GERD include multichannel intraluminal impedance (MII) probes and pH-sensing capsules. However, MII probes cause discomfort, which alters patients' regular activities, whereas the pH-sensing capsule lacks the ability to detect weak or nonacid episodes, misses reflux episodes with similar pH values, and has a limited sampling rate and battery life...
April 2013: Gastrointestinal Endoscopy
Frank Zerbib, Sabine Roman, Stanislas Bruley Des Varannes, Guillaume Gourcerol, Benoît Coffin, Alain Ropert, Patricia Lepicard, François Mion
BACKGROUND & AIMS: Combined pH and impedance monitoring can detect all types of reflux episodes within the esophageal lumen and the pharynx. We performed a multicenter study to establish normal values of pharyngeal and esophageal pH-impedance monitoring in individuals on and off therapy and to determine the interobserver reproducibility of this technique. METHODS: We collected ambulatory 24-hour pH-impedance recordings from 46 healthy subjects by using a bifurcated probe that allowed for detection of reflux events in the distal and proximal esophagus and pharynx...
April 2013: Clinical Gastroenterology and Hepatology
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