Findings of impedance pH-monitoring in patients with atypical gastroesophageal reflux symptoms.

AIM: This study was designed to investigate about findings of Impedance pH-monitoring in patients with atypical symptoms of GERD.

BACKGROUND: The routine treatment with proton pump inhibitors is not very effective in patients with atypical symptoms of Gastro-Esophageal Reflux Disease (GERD). It may be due to non-acid reflux which cannot be monitored using common methods such as pH-metry. Therefore, in these patients combinational procedure of multi channel intraluminal impedance and pH monitoring has been suggested as a new approach.

PATIENTS AND METHODS: Sixty patients with atypical symptoms of GERD underwent combined impedance pH-monitoring. pH of reflux episodes, type of material refluxant, blous cleaning time, proximal extension and symptoms association probability (SAP) was recorded for each patient.

RESULTS: Globus sensation was reported as the most common atypical symptom. 95% of patients experienced weakly acid reflux. Mixed and pure gas refluxates were more frequent than pure liquid reflux. Bolus clearing time was pathologic in 36.7% of cases and proximal extension was detected in 43 patients (71.7%). Of the 46 symptomatic patients, 33.3% had a positive SAP and 43.3% had a negative SAP.

CONCLUSION: The findings of current study showed that the combinational procedure of MII and pH monitoring could provide important information for resistant to treatment patients' with atypical GERD symptoms.