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Use of pH-impedance testing to evaluate patients with suspected extraesophageal manifestations of gastroesophageal reflux disease.
J Clin Gastroenterol 2008; 42(3):271-8JC

Abstract

GOALS

To report the use of pH-impedance testing in evaluating patients with suspected gastroesophageal reflux disease (GERD) with atypical symptoms.

BACKGROUND

Although the role of acid reflux in causing atypical GERD symptoms is generally accepted, the role, if any, of nonacid reflux is controversial, largely because until recently it has not been possible to detect nonacid reflux. The advent of intraluminal combined pH impedance testing (MII-pH), to detect nonacid reflux has heightened interest in its possible contribution to atypical symptoms.

STUDY

Fifty consecutive patients referred for MII-pH testing to evaluate the cause of atypical symptoms presumed due to GERD were evaluated. The symptoms were either refractory to acid inhibition therapy or so atypical that further work up was desired by the referring physician. Patients underwent MII-pH testing to determine whether reflux was present, and, if so, if it was due to acid, nonacid, or gas.

RESULTS

Only 16%, 22%, and 2% patients were found to have symptoms due to acid reflux, nonacid reflux, or both, respectively. Ten percent of these patients had gas reflux. MII-pH testing was useful in redirecting the management of patients who did not have reflux as the cause of their symptoms.

CONCLUSIONS

MII-pH testing is useful in determining whether gastroesophageal reflux is present in patients with atypical symptoms that have not responded to proton pump inhibitor therapy. It also distinguishes between reflux due to acid, nonacid, and gas, with consequences for management.

Authors+Show Affiliations

Department of Medicine, University of Connecticut Health Center, MC-1111, 263 Farmington Avenue, Farmington, CT-06030, USA. ashmalhotra@yahoo.comNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

18223497

Citation

Malhotra, Ashish, et al. "Use of pH-impedance Testing to Evaluate Patients With Suspected Extraesophageal Manifestations of Gastroesophageal Reflux Disease." Journal of Clinical Gastroenterology, vol. 42, no. 3, 2008, pp. 271-8.
Malhotra A, Freston JW, Aziz K. Use of pH-impedance testing to evaluate patients with suspected extraesophageal manifestations of gastroesophageal reflux disease. J Clin Gastroenterol. 2008;42(3):271-8.
Malhotra, A., Freston, J. W., & Aziz, K. (2008). Use of pH-impedance testing to evaluate patients with suspected extraesophageal manifestations of gastroesophageal reflux disease. Journal of Clinical Gastroenterology, 42(3), pp. 271-8. doi:10.1097/MCG.0b013e31802b64f3.
Malhotra A, Freston JW, Aziz K. Use of pH-impedance Testing to Evaluate Patients With Suspected Extraesophageal Manifestations of Gastroesophageal Reflux Disease. J Clin Gastroenterol. 2008;42(3):271-8. PubMed PMID: 18223497.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Use of pH-impedance testing to evaluate patients with suspected extraesophageal manifestations of gastroesophageal reflux disease. AU - Malhotra,Ashish, AU - Freston,James W, AU - Aziz,Khalid, PY - 2008/1/29/pubmed PY - 2008/5/28/medline PY - 2008/1/29/entrez SP - 271 EP - 8 JF - Journal of clinical gastroenterology JO - J. Clin. Gastroenterol. VL - 42 IS - 3 N2 - GOALS: To report the use of pH-impedance testing in evaluating patients with suspected gastroesophageal reflux disease (GERD) with atypical symptoms. BACKGROUND: Although the role of acid reflux in causing atypical GERD symptoms is generally accepted, the role, if any, of nonacid reflux is controversial, largely because until recently it has not been possible to detect nonacid reflux. The advent of intraluminal combined pH impedance testing (MII-pH), to detect nonacid reflux has heightened interest in its possible contribution to atypical symptoms. STUDY: Fifty consecutive patients referred for MII-pH testing to evaluate the cause of atypical symptoms presumed due to GERD were evaluated. The symptoms were either refractory to acid inhibition therapy or so atypical that further work up was desired by the referring physician. Patients underwent MII-pH testing to determine whether reflux was present, and, if so, if it was due to acid, nonacid, or gas. RESULTS: Only 16%, 22%, and 2% patients were found to have symptoms due to acid reflux, nonacid reflux, or both, respectively. Ten percent of these patients had gas reflux. MII-pH testing was useful in redirecting the management of patients who did not have reflux as the cause of their symptoms. CONCLUSIONS: MII-pH testing is useful in determining whether gastroesophageal reflux is present in patients with atypical symptoms that have not responded to proton pump inhibitor therapy. It also distinguishes between reflux due to acid, nonacid, and gas, with consequences for management. SN - 0192-0790 UR - https://www.unboundmedicine.com/medline/citation/18223497/Use_of_pH_impedance_testing_to_evaluate_patients_with_suspected_extraesophageal_manifestations_of_gastroesophageal_reflux_disease_ L2 - http://Insights.ovid.com/pubmed?pmid=18223497 DB - PRIME DP - Unbound Medicine ER -