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Relationship between baseline impedance levels and esophageal mucosal integrity in children with erosive and non-erosive reflux disease.
Neurogastroenterol Motil 2012; 24(9):828-e394NM

Abstract

BACKGROUND

Baseline impedance measurement has been reported to be related to esophageal acid exposure and hypothesized to be a marker of microscopic changes of the esophageal mucosa. Aims of the study were to establish whether any relationship existed between the magnitude of intercellular space diameter (ISD) of esophageal mucosa and baseline impedance levels in children with gastro-esophageal reflux disease (GERD), and to compare baseline impedance levels between children with non erosive (NERD) and erosive (ERD) reflux disease.

METHODS

Fifteen children (median age: 11.2 years) with NERD, and 11 with ERD (median age: 9.6 years) were prospectively studied. All patients underwent upper endoscopy. Biopsies were taken 2-3cm above the Z-line, and ISD was measured using transmission electron microscopy. All patients underwent impedance pH-monitoring, and baseline impedance levels were assessed in the most distal impedance channel.

KEY RESULTS

Mean (±SD) ISD did not differ between NERD (1.0±0.3μm) and ERD (1.1 ± 0.3 μm, ns). Considering all patients together, no correlation was found between distal baseline impedance and ISD (r: -0.15; ns). Conversely, negative correlations were found between distal baseline impedance and acid exposure time (r: -0.76; P<0.001), long-lasting reflux episodes (r: -0.78; P<0.001), acid reflux episodes (r: -0.62; P<0.001), and acid clearance time (r: -0.79; P<0.001). Distal baseline impedance was significantly lower in ERD [1455 (947-2338) Ω] than in NERD children [3065 (2253-3771) Ω; P<0.01].

CONCLUSIONS & INFERENCES

In children with GERD baseline impedance levels are not useful in predicting reflux-induced ultrastructural changes in the esophageal mucosa, despite their ability to discriminate between NERD and ERD.

Authors+Show Affiliations

Department of Gastroenterology, Neurogastroenterology and Motility Division, Great Ormond Street Hospital for Sick Children, London, UK. borreo@gosh.nhs.ukNo 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)

Comparative Study
Journal Article

Language

eng

PubMed ID

22680230

Citation

Borrelli, O, et al. "Relationship Between Baseline Impedance Levels and Esophageal Mucosal Integrity in Children With Erosive and Non-erosive Reflux Disease." Neurogastroenterology and Motility : the Official Journal of the European Gastrointestinal Motility Society, vol. 24, no. 9, 2012, pp. 828-e394.
Borrelli O, Salvatore S, Mancini V, et al. Relationship between baseline impedance levels and esophageal mucosal integrity in children with erosive and non-erosive reflux disease. Neurogastroenterol Motil. 2012;24(9):828-e394.
Borrelli, O., Salvatore, S., Mancini, V., Ribolsi, M., Gentile, M., Bizzarri, B., ... De'angelis, G. L. (2012). Relationship between baseline impedance levels and esophageal mucosal integrity in children with erosive and non-erosive reflux disease. Neurogastroenterology and Motility : the Official Journal of the European Gastrointestinal Motility Society, 24(9), pp. 828-e394. doi:10.1111/j.1365-2982.2012.01947.x.
Borrelli O, et al. Relationship Between Baseline Impedance Levels and Esophageal Mucosal Integrity in Children With Erosive and Non-erosive Reflux Disease. Neurogastroenterol Motil. 2012;24(9):828-e394. PubMed PMID: 22680230.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Relationship between baseline impedance levels and esophageal mucosal integrity in children with erosive and non-erosive reflux disease. AU - Borrelli,O, AU - Salvatore,S, AU - Mancini,V, AU - Ribolsi,M, AU - Gentile,M, AU - Bizzarri,B, AU - Cicala,M, AU - Lindley,K J, AU - De'angelis,G L, Y1 - 2012/06/11/ PY - 2012/6/12/entrez PY - 2012/6/12/pubmed PY - 2013/2/9/medline SP - 828 EP - e394 JF - Neurogastroenterology and motility : the official journal of the European Gastrointestinal Motility Society JO - Neurogastroenterol. Motil. VL - 24 IS - 9 N2 - BACKGROUND: Baseline impedance measurement has been reported to be related to esophageal acid exposure and hypothesized to be a marker of microscopic changes of the esophageal mucosa. Aims of the study were to establish whether any relationship existed between the magnitude of intercellular space diameter (ISD) of esophageal mucosa and baseline impedance levels in children with gastro-esophageal reflux disease (GERD), and to compare baseline impedance levels between children with non erosive (NERD) and erosive (ERD) reflux disease. METHODS: Fifteen children (median age: 11.2 years) with NERD, and 11 with ERD (median age: 9.6 years) were prospectively studied. All patients underwent upper endoscopy. Biopsies were taken 2-3cm above the Z-line, and ISD was measured using transmission electron microscopy. All patients underwent impedance pH-monitoring, and baseline impedance levels were assessed in the most distal impedance channel. KEY RESULTS: Mean (±SD) ISD did not differ between NERD (1.0±0.3μm) and ERD (1.1 ± 0.3 μm, ns). Considering all patients together, no correlation was found between distal baseline impedance and ISD (r: -0.15; ns). Conversely, negative correlations were found between distal baseline impedance and acid exposure time (r: -0.76; P<0.001), long-lasting reflux episodes (r: -0.78; P<0.001), acid reflux episodes (r: -0.62; P<0.001), and acid clearance time (r: -0.79; P<0.001). Distal baseline impedance was significantly lower in ERD [1455 (947-2338) Ω] than in NERD children [3065 (2253-3771) Ω; P<0.01]. CONCLUSIONS & INFERENCES: In children with GERD baseline impedance levels are not useful in predicting reflux-induced ultrastructural changes in the esophageal mucosa, despite their ability to discriminate between NERD and ERD. SN - 1365-2982 UR - https://www.unboundmedicine.com/medline/citation/22680230/Relationship_between_baseline_impedance_levels_and_esophageal_mucosal_integrity_in_children_with_erosive_and_non_erosive_reflux_disease_ L2 - https://doi.org/10.1111/j.1365-2982.2012.01947.x DB - PRIME DP - Unbound Medicine ER -