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Use of Direct, Endoscopic-Guided Measurements of Mucosal Impedance in Diagnosis of Gastroesophageal Reflux Disease.
MedLine Citation:
PMID:  22642956     Owner:  NLM     Status:  Publisher    
BACKGROUND & AIMS: Diagnostic tests for gastroesophageal reflux disease (GERD) are constrained because measurements are made at a single time point, so the long-term effects on the mucosa cannot be determined. We developed a minimally-invasive system to assess changes in esophageal mucosal impedance (MI), a marker of reflux. We measured the extent of changes in MI along the esophagus and show that the device to assess MI can be used to diagnose patients with GERD. METHODS: A single channel MI catheter composed of a unique sensor array was designed to easily traverse the working channel of an upper endoscope. We performed a prospective, longitudinal study of patients with erosive esophagitis (n=19), non-erosive but pH+ GERD (n=23), and those without GERD (n=27). MI was measured at the site of esophagitis as well as 2 cm, 5 cm, and 10 cm above the squamocolumnar junction (SCJ). The MI values were compared among groups, at different levels along the esophageal axis. RESULTS: Median MI values were significantly lower at the site of erosive mucosa (811 ohms, range 621-1272 ohms) than other non-erosive regions (3723 ohms, range 2421-4671 ohms; P =.001) and were significantly lower at 2 cm above SCJ in patients with GERD (2096 ohms, range 1415-2808 ohms), compared to those without GERD (3607 ohms, 1973-4238 ohms; P =0.008). There was a significant and graded increase in MI along the axis of the distal to proximal esophagus in patients with GERD that was not observed in individuals without reflux (P =.004). CONCLUSIONS: Measurements of MI along the esophagus can be used to identify patients with GERD.
Elif Saritas Yuksel; Tina Higginbotham; James C Slaughter; Jerry Mabary; Robert T Kavitt; C Gaelyn Garrett; Michael F Vaezi
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-5-26
Journal Detail:
Title:  Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association     Volume:  -     ISSN:  1542-7714     ISO Abbreviation:  -     Publication Date:  2012 May 
Date Detail:
Created Date:  2012-5-30     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101160775     Medline TA:  Clin Gastroenterol Hepatol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2012 AGA Institute. Published by Elsevier Inc. All rights reserved.
Division of Gastroenterology, Hepatology and Nutrition, Vanderbilt Medical Center, Nashville, TN, USA.
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