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Reflux patterns in patients with short-segment Barrett's oesophagus: a study using impedance-pH monitoring off and on proton pump inhibitor therapy.
Aliment Pharmacol Ther. 2009 Sep 01; 30(5):508-15.AP

Abstract

BACKGROUND

In short-segment Barrett's oesophagus (SSBO) heartburn may be absent and oesophageal acid exposure time (OAET) assessed with pH-only monitoring may be normal. By detecting reflux episodes independently of their acidity, multichannel intraluminal impedance-pH (MII-pH) monitoring allows a comprehensive characterization of reflux events, either off or on proton pump inhibitor (PPI) therapy.

AIM

To assess reflux parameters by MII-pH monitoring in newly diagnosed SSBO, at baseline and as modified with PPI therapy.

METHODS

Short-segment Barrett's oesophagus was defined by oesophageal intestinal metaplasia up to 3 cm in length. 24-h MII-pH monitoring was performed before and during PPI therapy.

RESULTS

Fifty patients were studied prospectively. Normal OAET was found at baseline in 15 patients (30%), 8 and 2 of whom with a higher than normal number of acid and weakly acidic refluxes, respectively. Overall, abnormal reflux parameters were detected by MII-pH monitoring in 90% of patients. Reflux events were prevalent in the upright period. On PPI therapy, acid refluxes decreased and a correspondent increase in weakly acidic refluxes was observed (median from 48.5 to 9 and from 16 to 57.5, respectively) (P < 0.001).

CONCLUSIONS

Acid refluxes, mainly in the upright period, characterize SSBO. PPI therapy transforms acid refluxes into weakly acidic refluxes.

Authors+Show Affiliations

Gastroenterologia - Nuovo Ospedale S. Agostino, Modena, Italy. m.frazzoni@ausl.mo.itNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

19519732

Citation

Frazzoni, M, et al. "Reflux Patterns in Patients With Short-segment Barrett's Oesophagus: a Study Using impedance-pH Monitoring Off and On Proton Pump Inhibitor Therapy." Alimentary Pharmacology & Therapeutics, vol. 30, no. 5, 2009, pp. 508-15.
Frazzoni M, Savarino E, Manno M, et al. Reflux patterns in patients with short-segment Barrett's oesophagus: a study using impedance-pH monitoring off and on proton pump inhibitor therapy. Aliment Pharmacol Ther. 2009;30(5):508-15.
Frazzoni, M., Savarino, E., Manno, M., Melotti, G., Mirante, V. G., Mussetto, A., Bertani, H., Manta, R., & Conigliaro, R. (2009). Reflux patterns in patients with short-segment Barrett's oesophagus: a study using impedance-pH monitoring off and on proton pump inhibitor therapy. Alimentary Pharmacology & Therapeutics, 30(5), 508-15. https://doi.org/10.1111/j.1365-2036.2009.04063.x
Frazzoni M, et al. Reflux Patterns in Patients With Short-segment Barrett's Oesophagus: a Study Using impedance-pH Monitoring Off and On Proton Pump Inhibitor Therapy. Aliment Pharmacol Ther. 2009 Sep 1;30(5):508-15. PubMed PMID: 19519732.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Reflux patterns in patients with short-segment Barrett's oesophagus: a study using impedance-pH monitoring off and on proton pump inhibitor therapy. AU - Frazzoni,M, AU - Savarino,E, AU - Manno,M, AU - Melotti,G, AU - Mirante,V G, AU - Mussetto,A, AU - Bertani,H, AU - Manta,R, AU - Conigliaro,R, Y1 - 2009/06/10/ PY - 2009/6/13/entrez PY - 2009/6/13/pubmed PY - 2010/4/17/medline SP - 508 EP - 15 JF - Alimentary pharmacology & therapeutics JO - Aliment Pharmacol Ther VL - 30 IS - 5 N2 - BACKGROUND: In short-segment Barrett's oesophagus (SSBO) heartburn may be absent and oesophageal acid exposure time (OAET) assessed with pH-only monitoring may be normal. By detecting reflux episodes independently of their acidity, multichannel intraluminal impedance-pH (MII-pH) monitoring allows a comprehensive characterization of reflux events, either off or on proton pump inhibitor (PPI) therapy. AIM: To assess reflux parameters by MII-pH monitoring in newly diagnosed SSBO, at baseline and as modified with PPI therapy. METHODS: Short-segment Barrett's oesophagus was defined by oesophageal intestinal metaplasia up to 3 cm in length. 24-h MII-pH monitoring was performed before and during PPI therapy. RESULTS: Fifty patients were studied prospectively. Normal OAET was found at baseline in 15 patients (30%), 8 and 2 of whom with a higher than normal number of acid and weakly acidic refluxes, respectively. Overall, abnormal reflux parameters were detected by MII-pH monitoring in 90% of patients. Reflux events were prevalent in the upright period. On PPI therapy, acid refluxes decreased and a correspondent increase in weakly acidic refluxes was observed (median from 48.5 to 9 and from 16 to 57.5, respectively) (P < 0.001). CONCLUSIONS: Acid refluxes, mainly in the upright period, characterize SSBO. PPI therapy transforms acid refluxes into weakly acidic refluxes. SN - 1365-2036 UR - https://www.unboundmedicine.com/medline/citation/19519732/Reflux_patterns_in_patients_with_short_segment_Barrett's_oesophagus:_a_study_using_impedance_pH_monitoring_off_and_on_proton_pump_inhibitor_therapy_ L2 - https://doi.org/10.1111/j.1365-2036.2009.04063.x DB - PRIME DP - Unbound Medicine ER -