Document Detail


Physical and pH properties of gastroesophagopharyngeal refluxate: a 24-hour simultaneous ambulatory impedance and pH monitoring study.
MedLine Citation:
PMID:  15180717     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: Frequency occurrence of nonacidic and nonliquid reflux events in the pharynx has not been systematically studied. The aim of the present study was to characterize the physical (liquid, gas, and mixed gas/liquid) and pH properties of the gastroesophagopharyngeal refluxate. METHODS: We performed a total of 31 24-h simultaneous ambulatory pharyngoesophageal impedance and pH recordings in 11 GERD patients, 10 patients with reflux-attributed laryngitis, and 10 healthy controls. RESULTS: On average, the total number of reflux events (all kinds) in the pharynx was less than half of that in the proximal esophagus (18 +/- 4 vs 50 +/- 4, p < 0.01). Most of the pharyngeal reflux events were gas events and were observed in all three studied groups. Prevalence of these gas reflux events ranged between 0 and 74. The number of gas reflux events accompanied by a minor pH drop in laryngitis patients (1 (0-36)) was significantly higher than those in GERD and controls (0 (0-2) and 0 (0-1), respectively, p < 0.05). There was no significant difference in the number of nonacidic gas reflux events among the three groups (GERD: 10 (2-57), laryngitis: 11.5 (0-51), controls: 10.5 (0-27)). Impedance recording identified a total number of 566 events in the pharynx. Of these, a total of 563 events were compatible with gas reflux events, 101 events were accompanied by minor drops in intrapharyngeal pH, whereas 460 events were not accompanied by any pharyngeal pH change. CONCLUSIONS: Concurrent impedance and pH recordings detect significantly more events qualifying as reflux in the pharynx than pH recordings alone. A substantial majority of these events are gaseous refluxes both with and without minor pH drops. Gas reflux events with weak acidity appear to be more common among patients with reflux-attributed laryngeal lesions compared to GERD patients and controls.
Authors:
Osamu Kawamura; Muhammad Aslam; Tanya Rittmann; Candy Hofmann; Reza Shaker
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  The American journal of gastroenterology     Volume:  99     ISSN:  0002-9270     ISO Abbreviation:  Am. J. Gastroenterol.     Publication Date:  2004 Jun 
Date Detail:
Created Date:  2004-06-07     Completed Date:  2004-08-06     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0421030     Medline TA:  Am J Gastroenterol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1000-10     Citation Subset:  IM    
Affiliation:
MCW Dysphagia Institute, Division of Gastroenterology and Hepatology, Medical College of Wisconsin, Milwaukee, Wisconsin, USA.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Case-Control Studies
Cohort Studies
Electric Impedance*
Female
Gastric Acid / metabolism*
Gastric Acidity Determination
Gastroesophageal Reflux / diagnosis,  metabolism*,  physiopathology
Humans
Hydrogen-Ion Concentration*
Laryngitis / metabolism*,  physiopathology
Male
Middle Aged
Monitoring, Ambulatory
Monitoring, Physiologic
Pharynx / metabolism*
Probability
Reference Values
Risk Factors
Sensitivity and Specificity
Severity of Illness Index
Comments/Corrections
Comment In:
Am J Gastroenterol. 2004 Jun;99(6):1020-2   [PMID:  15180719 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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