Diagnostic Efficacy of 24-hr Esophageal pH Monitoring in Patients with Refractory Gastroesophageal Reflux Disease
BACKGROUND: Gastric reflux is one of the most important causes of the referral of patients to the internal clinic, which in some cases causes problems for patients due to resistance to common treatments. Therefore, timely diagnosis and treatment of this group of patients are very important.
AIM: The purpose of the present study was to determine the off-proton pump inhibitor (off-PPI) 24 h pH-impedance analyses in patients with refractory gastroesophageal reflux disease (GERD) attending to Taleghani Hospital since 2009 to 2017.
METHODS: In this observational descriptive-comparative off-PPI study, 572 patients with refractory GERD who were referred to Taleghani Hospital in Tehran from 2009 to 2017 were selected, and the results of 24 h pH Impedance analysis were then assessed.
RESULTS: The results of 24h pH-impedance indicated that 7% of cases belonged to Pure Acid Reflux followed by weakly Acid (1%), non-acid (0.3%), mixed & gas (5.2%), functional (58.4%) and oesophagal hypersensitivity (28%). Furthermore, weakly acid plus acid was also found to be 8% and Weakly Acid + Acid + Non-Acid were determined as 8.3%.CONCLUSIONS: Our findings suggested that nearly more than half of the patients with refractory GERD would have a functional disorder in the 24h pH-impedance analysis.
Plum Analytics Artifact Widget Block
Chen T, Lu M, Wang X, et al. Prevalence and risk factors of gastroesophageal reflux symptoms in a Chinese retiree cohort. BMC Gastroenterol. 2012; 12:161. https://doi.org/10.1186/1471-230X-12-161 PMid:23153099 PMCid:PMC3573958
Sharma PK, Ahuja V, Madan K, Gupta S, Raizada A, Sharma MP. Prevalence, severity, and risk factors of symptomatic gastroesophageal reflux disease among employees of a large hospital in northern India. Indian J Gastroenterol. 2011; 30:128-34. https://doi.org/10.1007/s12664-010-0065-5 PMid:21061110
Malfertheiner P, HallerbÃ¤ck B. Clinical manifestations and complications of gastroesophageal reflux disease (GERD). Int J Clin Pract. 2005; 59:346-55. https://doi.org/10.1111/j.1742-1241.2005.00370.x PMid:15857335
Wahlqvist P. Symptoms of gastroesophageal reflux disease, perceived productivity, and health-related quality of life. Am J Gastroenterol. 2001; 96:S57-61. https://doi.org/10.1016/S0002-9270(01)02590-4
Gisbert JP, Cooper A, Karagiannis D, et al. Impact of gastroesophageal reflux disease on work absenteeism, presenteeism and productivity in daily life: a European observational study. Health Qual Life Outcomes. 2009; 7:90. https://doi.org/10.1186/1477-7525-7-90 PMid:19835583 PMCid:PMC2770561
Ciovica R, GadenstÃ¤tter M, Klingler A, Lechner W, Riedl O, Schwab GP. Quality of life in GERD patients: medical treatment versus antireflux surgery. J Gastrointest Surg. 2006; 10:934-9. https://doi.org/10.1016/j.gassur.2006.04.001 PMid:16843863
Scholten T. Long-term management of gastroesophageal reflux disease with pantoprazole. Ther Clin Risk Manag. 2007; 3:231-43. https://doi.org/10.2147/tcrm.2007.3.2.231 PMid:18360632 PMCid:PMC1936305
Wetscher GJ, Glaser K, Gadenstaetter M, Profanter C, Hinder RA. The effect of medical therapy and antireflux surgery on dysPHagia in patients with gastroesophageal reflux disease without esophageal stricture. Am J Surg. 1999; 177:189-92. https://doi.org/10.1016/S0002-9610(99)00011-2
Fass R, Gasiorowska A. Refractory GERD: what is it? Curr Gastroenterol Rep. 2008; 10:252-7. https://doi.org/10.1007/s11894-008-0052-5 PMid:18625135
Fass R. Functional heart burn. Gastroenterol Hepatol. 2014; 10:381-3.
Talaie R, Forootan M, Donboli K, et al. 24-hour ambulatory PH-metry in patients with refractory heartburn: a prospective study. J Gastrointestin Liver Dis. 2009; 18(1):11-5. PMid:19337627
Forootan M, Ardeshiri M, Etemadi N, Maghsoodi N, Poorsaadati S. Findings of impedance PH-monitoring in patients with atypical gastroesophageal reflux symptoms. Gastroenterol Hepatol Bed Bench. 2013; 6:S117-S121. PMid:24834281 PMCid:PMC4017544
Mirbagheri SA, Sadeghi A, Amouie M, et al. Pyloric injection of botulinum toxin for the treatment of Refractory GERD accompanied with gastroparesis: a preliminary report. Dig Dis Sci. 2008; 53:2621-6. https://doi.org/10.1007/s10620-007-0187-5 PMid:18256933
Ates F, Francis DO, Vaezi MF. Refractory gastroesophageal reflux disease: advances and treatment. Expert Rev Gastroenterol Hepatol. 2014; 8: 657-67. https://doi.org/10.1586/17474124.2014.910454 PMid:24745809
Serra Pueyo J. Update on gastroesophageal reflux disease. Gastroenterol Hepatol. 2014; 37: 73-82. https://doi.org/10.1016/j.gastrohep.2013.11.001 PMid:24355558
Haider SH, Kwon S, Lam R, et al. Predictive Biomarkers of Gastroesophageal Reflux Disease and Barrett's Esophagus in World Trade Center Exposed Firefighters: a 15 Year Longitudinal Study. Sci Rep. 2018; 8:3106. https://doi.org/10.1038/s41598-018-21334-9 PMid:29449669 PMCid:PMC5814524
Pritchett, Jason M. Efficacy of esophageal impedance/PH monitoring in patients with refractory gastroesoPHageal reflux disease, on and off therapy. Clinical Gastroenterology and Hepatology. 2009; 7: 743-8. https://doi.org/10.1016/j.cgh.2009.02.022 PMid:19281866
Penagini R, Sweis R, Mauro A, Domingues G, Vales A, Sifrim D. Inconsistency in the Diagnosis of Functional Heartburn: Usefulness of Prolonged Wireless PH Monitoring in Patients with Proton Pump Inhibitor Refractory Gastroesophageal Reflux Disease. J Neurogastroenterol Motil. 2015; 21:265-72. https://doi.org/10.5056/jnm14075 PMid:25843078 PMCid:PMC4398246
Frazzoni M, Conigliaro R, Mirante VG, Melotti G. The added value of quantitative analysis of on-therapy impedance-PH parameters in distinguishing refractory non-erosive reflux disease from functional heartburn. Neurogastroenterol Motil. 2012; 24(2):141-6, e87.
Savarino E, Marabotto E, Zentilin P, et al. The added value of impedance-PH monitoring to Rome III criteria in distinguishing functional heartburn from non-erosive reflux disease. Dig Liver Dis. 2011; 43:542-7. https://doi.org/10.1016/j.dld.2011.01.016 PMid:21376679
Jung HK, Halder S, McNally M, et al. Overlap of gastro-oesoPHageal reflux disease and irritable bowel syndrome: prevalence and risk factors in the general population. Aliment PHarmacol Ther. 2007; 26:453-61. https://doi.org/10.1111/j.1365-2036.2007.03366.x PMid:17635380
Savarino E, Pohl D, Zentilin P, et al. Functional heartburn has more in common with functional dyspepsia than with non-erosive reflux disease.Gut. 2009; 58:1185-91. https://doi.org/10.1136/gut.2008.175810 PMid:19460766 PMCid:PMC2719081
Khan MQ, Alaraj A, Alsohaibani F., et al. Diagnostic utility of impedance-PH monitoring in refractory non-erosive reflux disease. Journal of neurogastroenterology and motility. 2014; 20: 497-505. https://doi.org/10.5056/jnm14038 PMid:25273120 PMCid:PMC4204403
Herregods TV, Troelstra M, Weijenborg PW., et al. Patients with refractory reflux symptoms often do not have GERD. Neurogastroenterology Motility. 2015; 27: 1267-73. https://doi.org/10.1111/nmo.12620 PMid:26088946
Foroutan M, Loloei B, Irvani S, Azargashb E. Accuracy of rapid urease test in diagnosing Helicobacter pylori infection in patients using NSAIDs. Saudi J Gastroenterol. 2010; 16(2):110-112. https://doi.org/10.4103/1319-3767.61238 PMid:20339181 PMCid:PMC3016498
Keshavarz MA, Moradi S, Emami Z, Rohani F.Association between serum 25(OH) vitamin D and metabolic disturbances in polycystic ovary syndrome.Neth J Med. 2017; 75(5):190-195. PMid:28653944
Forootan M, Tabatabaeefar M, Mosaffa N, Ashkalak HR, Darvishi M.Investigating Esophageal Stent-Placement Outcomes in Patients with Inoperable Non-Cervical Esophageal Cancer.J Cancer. 2018; 9(1):213-218. https://doi.org/10.7150/jca.21854 PMid:29290788 PMCid:PMC5743730
Moradi S, Sahebi Z, Ebrahim Valojerdi A, Rohani F, Ebrahimi H.The association between the number of office visits and the control of cardiovascular risk factors in Iranian patients with type2 diabetes. PLoS One. 2017; 12(6):e0179190. https://doi.org/10.1371/journal.pone.0179190 PMid:28666031 PMCid:PMC5493291
Zare Mehrjardi M, Bagheri SM, Darabi M. Successful ultrasound-guided percutaneous embolization of renal pseudoaneurysm by autologous blood clot: Preliminary report of a new method. J Clin Ultrasound. 2017; 45(9):592-596. https://doi.org/10.1002/jcu.22462 PMid:28255997
All rights reserved.