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Characteristics and clinical relevance of proximal esophageal pH monitoring.
Am J Gastroenterol. 2004 Dec; 99(12):2317-23.AJ

Abstract

OBJECTIVE

It is well established that various ENT disorders and symptoms may be a manifestation of gastroesophageal reflux disease (GERD). Measuring proximal esophageal acid exposure might be useful in the evaluation of patients with suspected reflux-related ENT manifestations, but the limited available data are conflicting. The aim of the present study was to study the determinants of proximal esophageal acid exposure (PR) and to evaluate the clinical usefulness of ambulatory proximal pH monitoring.

METHODS

Twenty healthy controls and 346 patients with suspected reflux disease underwent typical and atypical GERD symptom assessment, endoscopy, esophageal manometry and ambulatory combined dual esophageal pH, and Bilitec duodeno-gastro-esophageal reflux exposure (DGER) monitoring. The presence of pathological PR and its relation to symptom pattern and distal esophageal acid exposure (DR) and DGER exposure were analyzed.

RESULTS

Fifty-seven patients (16%) had pathological PR. Demographic characteristics, symptom pattern, and manometric findings did not differ in patients with normal or pathological PR. Patients with pathological PR had significantly higher DR and DGER. The multivariate analysis identified only pathological DR as an independent risk factor for the presence of pathological PR (odds ratio 4.515, 95% CI 2.48-8.23, p < 0.0001). Only 20 patients (6%) had pathological proximal reflux without pathological distal acid reflux.

CONCLUSION

The findings of the present article do not support routine proximal esophageal pH monitoring as a clinical tool: PR does not differentiate patients with typical or atypical GERD manifestations and depends mainly on DR.

Authors+Show Affiliations

Department of Medicine, Division of Gastroenterology, University Hospitals Leuven, Belgium.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

15571576

Citation

Cool, Mike, et al. "Characteristics and Clinical Relevance of Proximal Esophageal pH Monitoring." The American Journal of Gastroenterology, vol. 99, no. 12, 2004, pp. 2317-23.
Cool M, Poelmans J, Feenstra L, et al. Characteristics and clinical relevance of proximal esophageal pH monitoring. Am J Gastroenterol. 2004;99(12):2317-23.
Cool, M., Poelmans, J., Feenstra, L., & Tack, J. (2004). Characteristics and clinical relevance of proximal esophageal pH monitoring. The American Journal of Gastroenterology, 99(12), 2317-23.
Cool M, et al. Characteristics and Clinical Relevance of Proximal Esophageal pH Monitoring. Am J Gastroenterol. 2004;99(12):2317-23. PubMed PMID: 15571576.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Characteristics and clinical relevance of proximal esophageal pH monitoring. AU - Cool,Mike, AU - Poelmans,Johan, AU - Feenstra,Louw, AU - Tack,Jan, PY - 2004/12/2/pubmed PY - 2005/2/3/medline PY - 2004/12/2/entrez SP - 2317 EP - 23 JF - The American journal of gastroenterology JO - Am J Gastroenterol VL - 99 IS - 12 N2 - OBJECTIVE: It is well established that various ENT disorders and symptoms may be a manifestation of gastroesophageal reflux disease (GERD). Measuring proximal esophageal acid exposure might be useful in the evaluation of patients with suspected reflux-related ENT manifestations, but the limited available data are conflicting. The aim of the present study was to study the determinants of proximal esophageal acid exposure (PR) and to evaluate the clinical usefulness of ambulatory proximal pH monitoring. METHODS: Twenty healthy controls and 346 patients with suspected reflux disease underwent typical and atypical GERD symptom assessment, endoscopy, esophageal manometry and ambulatory combined dual esophageal pH, and Bilitec duodeno-gastro-esophageal reflux exposure (DGER) monitoring. The presence of pathological PR and its relation to symptom pattern and distal esophageal acid exposure (DR) and DGER exposure were analyzed. RESULTS: Fifty-seven patients (16%) had pathological PR. Demographic characteristics, symptom pattern, and manometric findings did not differ in patients with normal or pathological PR. Patients with pathological PR had significantly higher DR and DGER. The multivariate analysis identified only pathological DR as an independent risk factor for the presence of pathological PR (odds ratio 4.515, 95% CI 2.48-8.23, p < 0.0001). Only 20 patients (6%) had pathological proximal reflux without pathological distal acid reflux. CONCLUSION: The findings of the present article do not support routine proximal esophageal pH monitoring as a clinical tool: PR does not differentiate patients with typical or atypical GERD manifestations and depends mainly on DR. SN - 0002-9270 UR - https://www.unboundmedicine.com/medline/citation/15571576/Characteristics_and_clinical_relevance_of_proximal_esophageal_pH_monitoring_ L2 - https://doi.org/10.1111/j.1572-0241.2004.40626.x DB - PRIME DP - Unbound Medicine ER -