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Mucosal Impedance Discriminates Gerd From Non-Gerd Conditions.
MedLine Citation:
PMID:  25448923     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND&AIMS: Current diagnostic tests for gastroesophageal reflux disease (GERD) are suboptimal and do not accurately and reliably measure chronicity of reflux. A minimally invasive device has been developed to assess esophageal mucosal impedance (MI) as a marker of chronic reflux. We performed a prospective longitudinal study to investigate patterns of MI in patients with GERD and common non-reflux conditions, to assess MI patterns before and after treatment with proton pump inhibitors, and to compare the performance of MI and wireless pH tests.
METHODS: We evaluated MI in 61 patients with erosive esophagitis, 81 with non-erosive but pH+ GERD, 93 without GERD, 18 with achalasia, and 15 with eosinophilic esophagitis. MI was measured at the site of esophagitis and at 2, 5, and 10 cm above the squamo-columnar junction in all participants. MI was measured before and after acid-suppressive therapy and findings were compared with those from wireless pH monitoring.
RESULTS: MI values were significantly lower in patients with GERD (erosive esophagitis or non-erosive, pH+ GERD) or eosinophilic esophagitis than in patients without GERD or patients with achalasia (P<0.001). The pattern of MI in patients with GERD differed from that of patients without GERD or patients with eosinophilic esophagitis; patients with GERD had low MI closer to the squamo-columnar junction and values increased axially along the esophagus. These patterns normalized with acid suppressive therapy. MI patterns identified patients with esophagitis with higher levels of specificity (95%) and positive predictive values (96%) than wireless pH monitoring (64% and 40%, respectively).
CONCLUSIONS: Based on a prospective study employing a prototype device, measurements of MI detect GERD with higher levels of specificity and positive predictive values than wireless pH monitoring. Clinical Trials.gov, NCT01556919.
Authors:
Fehmi Ates; Tina Higginbotham; James C Slaughter; Jerry Mabary; Robert T Kavitt; C Gaelyn Garrett; David Francis; Michael F Vaezi
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2014-10-16
Journal Detail:
Title:  Gastroenterology     Volume:  -     ISSN:  1528-0012     ISO Abbreviation:  Gastroenterology     Publication Date:  2014 Oct 
Date Detail:
Created Date:  2014-12-2     Completed Date:  -     Revised Date:  2014-12-3    
Medline Journal Info:
Nlm Unique ID:  0374630     Medline TA:  Gastroenterology     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2014 AGA Institute. Published by Elsevier Inc. All rights reserved.
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