OBJECTIVE: In some patients with a physiological esophageal acid exposure, an association between reflux episodes and symptoms can be demonstrated. Besides acidity, other factors such as proximal extent may determine whether a reflux episode is perceived or not. We aimed to investigate the reflux profile of gastroesophageal reflux disease (GERD) patients with physiological acid exposure. METHODS: Twenty-four-hour impedance-pH monitoring was performed in 14 GERD patients with excessive acid exposure (pH+), 14 GERD patients with physiological acid exposure (pH-), and 14 controls. All patients had a positive symptom-reflux association during 24-h monitoring (SAP+). RESULTS: The incidence of acid reflux episodes in pH- SAP+ patients (25.5 +/- 4.9) and controls (20.2 +/- 3.9) was comparable, but lower than in pH+ SAP+ patients (69.8 +/- 7.3). However, no differences in number of weakly acidic reflux episodes were observed among pH- SAP+ patients, pH+ SAP+ patients, and controls (27.2 +/- 3.8 vs 26.8 +/- 4.6 and 21.0 +/- 3.7, respectively). The proportion of reflux episodes that reached the proximal esophagus was significantly higher in the pH+ SAP+ (33.5%) and pH- SAP+ (36.0%) patients than in the controls (19.5%). Volume clearance time was longer in pH+ SAP+ (12.5 [12.5-17.0] s) compared with pH- SAP+ patients (12.0 [11.0-16.5] s) and controls (9.5 [10.0-12.5] s) (P < 0.05). Acid clearance time was also longer in pH+ SAP+ patients (55.0 [32.0-64.0] s) compared with the pH- SAP+ (16.5 [11.4-40.0] s) and controls (14 [12.0-19.1] s) (P < 0.01). CONCLUSIONS: In pH- SAP+ patients, a higher proportion of reflux episodes reach the proximal esophagus than in controls. This can in part explain their symptoms.
OBJECTIVE: In some patients with a physiological esophageal acid exposure, an association between reflux episodes and symptoms can be demonstrated. Besides acidity, other factors such as proximal extent may determine whether a reflux episode is perceived or not. We aimed to investigate the reflux profile of gastroesophageal reflux disease (GERD) patients with physiological acid exposure. METHODS: Twenty-four-hour impedance-pH monitoring was performed in 14 GERDpatients with excessive acid exposure (pH+), 14 GERDpatients with physiological acid exposure (pH-), and 14 controls. All patients had a positive symptom-reflux association during 24-h monitoring (SAP+). RESULTS: The incidence of acid reflux episodes in pH- SAP+ patients (25.5 +/- 4.9) and controls (20.2 +/- 3.9) was comparable, but lower than in pH+ SAP+ patients (69.8 +/- 7.3). However, no differences in number of weakly acidic reflux episodes were observed among pH- SAP+ patients, pH+ SAP+ patients, and controls (27.2 +/- 3.8 vs 26.8 +/- 4.6 and 21.0 +/- 3.7, respectively). The proportion of reflux episodes that reached the proximal esophagus was significantly higher in the pH+ SAP+ (33.5%) and pH- SAP+ (36.0%) patients than in the controls (19.5%). Volume clearance time was longer in pH+ SAP+ (12.5 [12.5-17.0] s) compared with pH- SAP+ patients (12.0 [11.0-16.5] s) and controls (9.5 [10.0-12.5] s) (P < 0.05). Acid clearance time was also longer in pH+ SAP+ patients (55.0 [32.0-64.0] s) compared with the pH- SAP+ (16.5 [11.4-40.0] s) and controls (14 [12.0-19.1] s) (P < 0.01). CONCLUSIONS: In pH- SAP+ patients, a higher proportion of reflux episodes reach the proximal esophagus than in controls. This can in part explain their symptoms.
Authors: Karl Hermann Fuchs; Benjamin Babic; Wolfram Breithaupt; Bernard Dallemagne; Abe Fingerhut; Edgar Furnee; Frank Granderath; Peter Horvath; Peter Kardos; Rudolph Pointner; Edoardo Savarino; Maud Van Herwaarden-Lindeboom; Giovanni Zaninotto Journal: Surg Endosc Date: 2014-05-02 Impact factor: 4.584
Authors: Boudewijn F Kessing; Joris A J L Broeders; Nikki Vinke; Marlies P Schijven; Eric J Hazebroek; Ivo A M J Broeders; Albert J Bredenoord; André J P M Smout Journal: Surg Endosc Date: 2013-05-01 Impact factor: 4.584
Authors: Cary C Cotton; Lucas C Duits; W Asher Wolf; Anne F Peery; Evan S Dellon; Jacques J Bergman; Nicholas J Shaheen Journal: Am J Gastroenterol Date: 2015-09-08 Impact factor: 10.864