Authors: C Gruebel G Linke R Tutuian G Hebbard A Zerz C Meyenberger J Borovicka
Publish Date: 2007/10/18
Volume: 22, Issue: 5, Pages: 1241-1247
Abstract
Reflux monitoring using combined multichannel intraluminal impedance MII and pHmetry increases the sensitivity for identifying gastroesophageal reflux episodes The likelihood of a positive symptom index SI for patients with reflux disease gastroesophageal reflux disease GERD or nonerosive reflux disease NERD receiving proton pump inhibitor PPI treatment has been used to select candidates for antireflux surgery Little is known about the advantages of MIIpH monitoring compared with pH monitoring alone for evaluating GERD/NERD patients off PPI treatment considered as candidates for antireflux surgery or for assessing changes in MIIpHdetected reflux episodes after antireflux surgery This study aimed to determine the additional value of MII over pHmetry alone for patients off PPI treatment before and after antireflux surgeryFor this study 12 patients 4 women and 8 men mean age 45 years range 27–74 years were evaluated using ambulatory MIIpH monitoring before and 3 months after meshaugmented hiatoplasty Reflux events were identified by MIIpH A and pHmetry B as patients recorded symptoms on a data logger For each symptom a symptom index was calculated for reflux events identified by MIIpH and by pHmonitoring alonePreoperatively MIIpH monitoring identified 719 ± 84 reflux episodes whereas pH monitoring identified only 510 ± 78 p 005 Postoperatively MIIpH monitoring identified 355 ± 66 reflux episodes whereas pH monitoring identified only 196 ± 47 p 005 The pre and postoperative symptom index for MIIpH monitoring was higher than pH monitoring preoperative 917 vs 25 p = 0006 postoperative 50 vs 167 p = 0012
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