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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.

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Authors+Show Affiliations

Frazzoni M
Gastroenterologia - Nuovo Ospedale S. Agostino, Modena, Italy. m.frazzoni@ausl.mo.it
Savarino E
No affiliation info available
Manno M
No affiliation info available
Melotti G
No affiliation info available
Mirante VG
No affiliation info available
Mussetto A
No affiliation info available
Bertani H
No affiliation info available
Manta R
No affiliation info available
Conigliaro R
No affiliation info available

MeSH

AdolescentAdultAgedAnti-Ulcer AgentsBarrett EsophagusEsophageal pH MonitoringFemaleGastroesophageal RefluxHeartburnHumansHydrogen-Ion ConcentrationMaleManometryMiddle AgedProspective StudiesProton Pump InhibitorsYoung Adult

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 -