Document Detail

Subcardial 24-h wireless pH monitoring in gastroesophageal reflux disease patients with and without hiatal hernia compared with healthy subjects.
MedLine Citation:
PMID:  19638965     Owner:  NLM     Status:  MEDLINE    
OBJECTIVES: After meals, highly acidic gastric juice is present in the subcardial region, the so-called acid pocket. Patients with gastroesophageal reflux disease (GERD) have a higher frequency of acidic reflux. Our aim was to investigate the possible differences in subcardial pH in GERD over 24 h and the role of hiatal hernia (HH), using a wireless capsule. METHODS: A total of 14 healthy volunteers (4 men, 24-60 years), 10 GERD patients without HH (4 men, 25-68 years), and 11 GERD patients with HH >or=3 cm (2 men, 46-74 years) underwent 24-h wireless pH monitoring 2 cm below the squamocolumnar junction. All patients had increased 24-h acid reflux. A standardized lunch was given to all study subjects. RESULTS: No capsule detached during the 24-h recording. Median 24-h pH was similar in healthy subjects, and in patients without and with HH, median: 1.4 (interquartile range: 1.2 -1.9), 1.5 (1.3 -1.7), and 1.4 (1.3 -1.7), respectively. Similar results were seen in the supine period. Median pH after the standardized meal was often highly acidic, 2.7 (1.5 - 3.2), 1.9 (1.6 - 2.3), and 2.5 (1.6 - 3.2), respectively. The first minute with a median pH <2 occurred 14 min (4 - 49), 14 min (6 - 25), and 20 min (4 - 43), respectively, P=NS, after the end of the meal. Similar data were observed on pooling all meals together. CONCLUSIONS: Subcardial pH is confirmed to be highly acidic early after meals, but it is similar over 24 h in healthy subjects and GERD patients independent of the presence of HH.
Ausilia Grigolon; Paolo Cantú; Ivana Bravi; Chiara Caparello; Roberto Penagini
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't     Date:  2009-07-28
Journal Detail:
Title:  The American journal of gastroenterology     Volume:  104     ISSN:  1572-0241     ISO Abbreviation:  Am. J. Gastroenterol.     Publication Date:  2009 Nov 
Date Detail:
Created Date:  2009-11-05     Completed Date:  2009-12-01     Revised Date:  2010-01-07    
Medline Journal Info:
Nlm Unique ID:  0421030     Medline TA:  Am J Gastroenterol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  2714-20     Citation Subset:  IM    
Cattedra di Gastroenterologia, Dipartimento di Scienze Mediche, Università degli Studi of Milan, Milan, Italy.
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MeSH Terms
Capsule Endoscopy*
Case-Control Studies
Electric Impedance / diagnostic use
Esophageal pH Monitoring / instrumentation*
Follow-Up Studies
Gastric Acidity Determination
Gastroesophageal Reflux / complications,  diagnosis*
Hernia, Hiatal / complications,  diagnosis*
Hydrogen-Ion Concentration
Middle Aged
Postprandial Period
Reference Values
Severity of Illness Index
Statistics, Nonparametric
Supine Position
Time Factors
Comment In:
Am J Gastroenterol. 2010 Jan;105(1):225-6; author reply 226   [PMID:  20054316 ]

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

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