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Regional oesophageal sensitivity to acid and weakly acidic reflux in patients with non-erosive reflux disease.
Neurogastroenterol Motil 2009; 21(3):253-8NM

Abstract

The mechanisms underlying symptoms in non-erosive reflux disease (NERD) remain to be elucidated. Non-erosive reflux disease patients appear to be more sensitive to intraluminal stimula than erosive patients, the proximal oesophagus being the most sensitive. In order to assess regional oesophageal changes in reflux acidity and sensitivity to reflux, according either to the acidity or the composition of the refluxate, combined multiple pH and multiple pH-impedance (pH-MII) was performed in 16 NERD patients. According to multiple pH-metry, 29% and 12% of reflux events reached the middle and proximal oesophagus respectively, and 35% and 19% according to conventional pH-MII (P < 0.05). The per-individual analysis confirmed the difference between the two techniques. According to combined distal and proximal pH-MII, approximately 30% of distal acid reflux became weakly acidic at the proximal oesophagus. In all patients, the frequency of symptomatic refluxes, both acid and weakly acidic, was significantly higher at the proximal, compared with distal oesophagus (25 +/- 8%vs 11 +/- 2% for acid reflux and 27 +/- 8%vs 8 +/- 2% for weakly acidic reflux; P < 0.05). Compared with multiple pH-metry, pH-MII shows a higher sensitivity in the detection of proximal reflux. As approximately 30% of acid reflux becomes weakly acidic along the oesophageal body, to better characterize proximal reflux, in clinical practice, combined proximal pH-impedance monitoring should be used. In NERD patients, the proximal oesophagus seems to be more sensitive to both acid and weakly acidic reflux.

Authors+Show Affiliations

Department of Digestive Disease, University Campus Bio Medico, Rome, Italy. s.emerenziani@unicampus.itNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

19019016

Citation

Emerenziani, S, et al. "Regional Oesophageal Sensitivity to Acid and Weakly Acidic Reflux in Patients With Non-erosive Reflux Disease." Neurogastroenterology and Motility : the Official Journal of the European Gastrointestinal Motility Society, vol. 21, no. 3, 2009, pp. 253-8.
Emerenziani S, Ribolsi M, Sifrim D, et al. Regional oesophageal sensitivity to acid and weakly acidic reflux in patients with non-erosive reflux disease. Neurogastroenterol Motil. 2009;21(3):253-8.
Emerenziani, S., Ribolsi, M., Sifrim, D., Blondeau, K., & Cicala, M. (2009). Regional oesophageal sensitivity to acid and weakly acidic reflux in patients with non-erosive reflux disease. Neurogastroenterology and Motility : the Official Journal of the European Gastrointestinal Motility Society, 21(3), pp. 253-8. doi:10.1111/j.1365-2982.2008.01203.x.
Emerenziani S, et al. Regional Oesophageal Sensitivity to Acid and Weakly Acidic Reflux in Patients With Non-erosive Reflux Disease. Neurogastroenterol Motil. 2009;21(3):253-8. PubMed PMID: 19019016.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Regional oesophageal sensitivity to acid and weakly acidic reflux in patients with non-erosive reflux disease. AU - Emerenziani,S, AU - Ribolsi,M, AU - Sifrim,D, AU - Blondeau,K, AU - Cicala,M, Y1 - 2008/10/07/ PY - 2008/11/21/pubmed PY - 2009/5/2/medline PY - 2008/11/21/entrez SP - 253 EP - 8 JF - Neurogastroenterology and motility : the official journal of the European Gastrointestinal Motility Society JO - Neurogastroenterol. Motil. VL - 21 IS - 3 N2 - The mechanisms underlying symptoms in non-erosive reflux disease (NERD) remain to be elucidated. Non-erosive reflux disease patients appear to be more sensitive to intraluminal stimula than erosive patients, the proximal oesophagus being the most sensitive. In order to assess regional oesophageal changes in reflux acidity and sensitivity to reflux, according either to the acidity or the composition of the refluxate, combined multiple pH and multiple pH-impedance (pH-MII) was performed in 16 NERD patients. According to multiple pH-metry, 29% and 12% of reflux events reached the middle and proximal oesophagus respectively, and 35% and 19% according to conventional pH-MII (P < 0.05). The per-individual analysis confirmed the difference between the two techniques. According to combined distal and proximal pH-MII, approximately 30% of distal acid reflux became weakly acidic at the proximal oesophagus. In all patients, the frequency of symptomatic refluxes, both acid and weakly acidic, was significantly higher at the proximal, compared with distal oesophagus (25 +/- 8%vs 11 +/- 2% for acid reflux and 27 +/- 8%vs 8 +/- 2% for weakly acidic reflux; P < 0.05). Compared with multiple pH-metry, pH-MII shows a higher sensitivity in the detection of proximal reflux. As approximately 30% of acid reflux becomes weakly acidic along the oesophageal body, to better characterize proximal reflux, in clinical practice, combined proximal pH-impedance monitoring should be used. In NERD patients, the proximal oesophagus seems to be more sensitive to both acid and weakly acidic reflux. SN - 1365-2982 UR - https://www.unboundmedicine.com/medline/citation/19019016/Regional_oesophageal_sensitivity_to_acid_and_weakly_acidic_reflux_in_patients_with_non_erosive_reflux_disease_ L2 - https://doi.org/10.1111/j.1365-2982.2008.01203.x DB - PRIME DP - Unbound Medicine ER -