Document Detail

The utility of intraluminal impedance in patients with gastroesophageal reflux disease-like symptoms but normal endoscopy and 24-hour pH testing.
MedLine Citation:
PMID:  18424190     Owner:  NLM     Status:  MEDLINE    
BACKGROUND & AIMS: Fifty percent of patients with gastroesophageal reflux disease-like symptoms and negative endoscopy have negative 24-hour pH testing, suggesting that symptoms are not caused by abnormal esophageal acid exposure. Multichannel intraluminal impedance (MII)-24-hour pH allows the recognition of major acid, minor acid, nonacid, and gas reflux. Recorded symptoms can be correlated with all reflux events (eg, acid, minor acid, nonacid, and gas) and a symptom score can be generated. We aimed to determine whether the Symptom Index (SI) obtained using MII-pH identified an association of symptoms with reflux events in nonclassic acid-reflux disease. METHODS: Thirty-seven patients with heartburn or regurgitation, negative endoscopy, and 24-hour pH were enlisted. Acid suppression was stopped, a 24-hour MII-pH test was performed, and an SI was calculated for major acid reflux alone and for all reflux episodes including major, minor, and nonacid. On this basis patients were divided into 4 groups: (1) standard acid reflux: positive standard pH test; (2) acid sensitive: positive SI for major acid but normal pH test; (3) general reflux: positive SI for major, minor, and nonacid combined, but not for major acid alone; and (4) no reflux: negative SI. RESULTS: Six patients (16%) had standard reflux, 10 patients (27%) had acid-sensitive esophagus, 14 patients (38%) had general reflux, and 7 patients (19%) had a negative SI. CONCLUSIONS: Fifty-seven percent of patients received a diagnosis unachievable with standard pH testing (38% had symptoms associated with general reflux and 19% had no reflux symptom associations). These findings support a potential role for MII-pH testing in this difficult group.
Michael M Kline; Mark Ewing; Nicole Simpson; Loren Laine
Publication Detail:
Type:  Journal Article     Date:  2008-04-18
Journal Detail:
Title:  Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association     Volume:  6     ISSN:  1542-7714     ISO Abbreviation:  Clin. Gastroenterol. Hepatol.     Publication Date:  2008 Aug 
Date Detail:
Created Date:  2008-08-04     Completed Date:  2008-10-23     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101160775     Medline TA:  Clin Gastroenterol Hepatol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  880-5; quiz 836     Citation Subset:  IM    
Department of Medicine, Division of Gastroenterology, University of Southern California Keck School of Medicine, Los Angeles, California 90033, USA.
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MeSH Terms
Electric Impedance / diagnostic use*
Gastroesophageal Reflux / diagnosis*,  physiopathology*
Hydrogen-Ion Concentration
Middle Aged
Sensitivity and Specificity
Comment In:
Clin Gastroenterol Hepatol. 2008 Aug;6(8):840-1   [PMID:  18585975 ]

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

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