Document Detail

Pathological bolus exposure may define gastro-esophageal reflux better than pathological Acid exposure in patients with globus.
MedLine Citation:
PMID:  22353495     Owner:  NLM     Status:  In-Data-Review    
Background/Aims: Conventionally, pathological acid exposure (PAE), defined by acid reflux only, is used to identify gastro-esophageal reflux disease (GERD). However, weak acid reflux or non-acid reflux also induces reflux symptoms. Defining abnormal reflux based on all reflux episodes may better identify GERD and would be more useful among patients with atypical GERD symptoms, such as globus. Methodology: Impedance-pHmetry results of 31 globus patients, off acid suppressants, were analysed. Results: A median of 24 episodes of reflux were observed. Of the reflux episodes, 54% were non-acid reflux and 50% reached the proximal extent. PAE was observed in 6 patients (19%). For 5 patients (16%) without PAE, there was evidence of increased bolus exposure compared to normal controls (an intraesophageal bolus exposure for more than 1.4% of the recording time, defined as pathological bolus exposure, PBE). When GERD was defined by PAE or esophagitis, the prevalence of GERD was 29%. When GERD was defined by PBE, PAE or esophagitis, the prevalence was 42%. PBE identified 13% of the patients who otherwise would have been missed. Conclusions: A significant proportion of patients without PAE had evidence of PBE. PBE may be a more useful definition for identifying patients with abnormal increase in reflux in patients with globus. Further studies are warranted.
Dong Hyun Sinn; Beom Jin Kim; Hee Jung Son; Jae J Kim; Jong Chul Rhee; Poong-Lyul Rhee
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Hepato-gastroenterology     Volume:  59     ISSN:  0172-6390     ISO Abbreviation:  Hepatogastroenterology     Publication Date:    2012 Mar-Apr
Date Detail:
Created Date:  2012-02-22     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8007849     Medline TA:  Hepatogastroenterology     Country:  Greece    
Other Details:
Languages:  eng     Pagination:  317-20     Citation Subset:  IM    
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