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Value of extended recording time with wireless pH monitoring in evaluating gastroesophageal reflux disease.

Abstract

BACKGROUND & AIMS

Extending an ambulatory pH study by using a wireless capsule system could improve diagnosis of gastroesophageal reflux disease in patients with symptoms potentially related to acid reflux events. We determined the relative value of a 2-day versus a 1-day study in detection of abnormal esophageal acid exposure and reflux symptom associations.

METHODS

Subjects who had undergone pH monitoring with the wireless system for symptom evaluation and who had at least 1 typical or atypical symptom during monitoring were studied (n = 157). Acid exposure time, symptom index, and a measure of reflux-associated symptom probability were calculated after 1 day of recording and compared to final results from analysis of 2 days of data.

RESULTS

Extending recording time increased the number of subjects recording symptoms by 6.8% and doubled the number of symptoms available for association with acid reflux events. Other advantages were greater in subjects off antireflux therapy, wherein lengthening recording time increased the proportion of subjects with abnormal acid exposure time by 12.4% and significantly increased the likelihood of a positive reflux symptom relationship in subjects with atypical symptoms. Accuracy of a 1-day study ranged from 0.87-0.88 for acid exposure time to as low as 0.72-0.87 for the probability test, the most sensitive of the symptom association tests.

CONCLUSIONS

Extending recording time to 2 days with the wireless pH monitoring system increases the likelihood of detecting reflux disease in patients undergoing symptom evaluation. Benefits are most evident for subjects with atypical symptoms and for establishing reflux symptom associations by probability testing.

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  • Authors+Show Affiliations

    ,

    Division of Gastroenterology, Washington University School of Medicine, 660 S. Euclid Avenue, Campus Box 8124, St. Louis, MO 63110, USA. cprakash@im.wustl.edu

    Source

    MeSH

    Adult
    Cohort Studies
    Female
    Gastric Acidity Determination
    Gastroesophageal Reflux
    Humans
    Hydrogen-Ion Concentration
    Male
    Middle Aged
    Monitoring, Physiologic
    Predictive Value of Tests
    Prognosis
    Proton Pump Inhibitors
    Proton Pumps
    Sensitivity and Specificity
    Severity of Illness Index
    Time Factors
    Treatment Outcome

    Pub Type(s)

    Comparative Study
    Journal Article
    Research Support, Non-U.S. Gov't

    Language

    eng

    PubMed ID

    15822037

    Citation

    Prakash, Chandra, and Ray E. Clouse. "Value of Extended Recording Time With Wireless pH Monitoring in Evaluating Gastroesophageal Reflux Disease." Clinical Gastroenterology and Hepatology : the Official Clinical Practice Journal of the American Gastroenterological Association, vol. 3, no. 4, 2005, pp. 329-34.
    Prakash C, Clouse RE. Value of extended recording time with wireless pH monitoring in evaluating gastroesophageal reflux disease. Clin Gastroenterol Hepatol. 2005;3(4):329-34.
    Prakash, C., & Clouse, R. E. (2005). Value of extended recording time with wireless pH monitoring in evaluating gastroesophageal reflux disease. Clinical Gastroenterology and Hepatology : the Official Clinical Practice Journal of the American Gastroenterological Association, 3(4), pp. 329-34.
    Prakash C, Clouse RE. Value of Extended Recording Time With Wireless pH Monitoring in Evaluating Gastroesophageal Reflux Disease. Clin Gastroenterol Hepatol. 2005;3(4):329-34. PubMed PMID: 15822037.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Value of extended recording time with wireless pH monitoring in evaluating gastroesophageal reflux disease. AU - Prakash,Chandra, AU - Clouse,Ray E, PY - 2005/4/12/pubmed PY - 2005/6/29/medline PY - 2005/4/12/entrez SP - 329 EP - 34 JF - Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association JO - Clin. Gastroenterol. Hepatol. VL - 3 IS - 4 N2 - BACKGROUND & AIMS: Extending an ambulatory pH study by using a wireless capsule system could improve diagnosis of gastroesophageal reflux disease in patients with symptoms potentially related to acid reflux events. We determined the relative value of a 2-day versus a 1-day study in detection of abnormal esophageal acid exposure and reflux symptom associations. METHODS: Subjects who had undergone pH monitoring with the wireless system for symptom evaluation and who had at least 1 typical or atypical symptom during monitoring were studied (n = 157). Acid exposure time, symptom index, and a measure of reflux-associated symptom probability were calculated after 1 day of recording and compared to final results from analysis of 2 days of data. RESULTS: Extending recording time increased the number of subjects recording symptoms by 6.8% and doubled the number of symptoms available for association with acid reflux events. Other advantages were greater in subjects off antireflux therapy, wherein lengthening recording time increased the proportion of subjects with abnormal acid exposure time by 12.4% and significantly increased the likelihood of a positive reflux symptom relationship in subjects with atypical symptoms. Accuracy of a 1-day study ranged from 0.87-0.88 for acid exposure time to as low as 0.72-0.87 for the probability test, the most sensitive of the symptom association tests. CONCLUSIONS: Extending recording time to 2 days with the wireless pH monitoring system increases the likelihood of detecting reflux disease in patients undergoing symptom evaluation. Benefits are most evident for subjects with atypical symptoms and for establishing reflux symptom associations by probability testing. SN - 1542-3565 UR - https://www.unboundmedicine.com/medline/citation/15822037/Value_of_extended_recording_time_with_wireless_pH_monitoring_in_evaluating_gastroesophageal_reflux_disease_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1542356505000212 DB - PRIME DP - Unbound Medicine ER -