First Agreement Analysis and Day-to-Day Comparison of Pharyngeal pH Monitoring with pH/Impedance Monitoring in Patients with Suspected Laryngopharyngeal Reflux

Becker V, Graf S, Schlag C, et al. J Gastrointest Surg. 2012;16(6):1096-101.

OBJECTIVES: Diagnosis of laryngopharyngeal reflux (LPR) is still challenging. Recently a diagnostic device for pH values in the aerosolized environment of the pharynx has been introduced (Dx-pH). We evaluated results of Dx-pH with objective criteria of pH/impedance monitoring (MII) and subjective reflux scoring systems and assessed day-to-day variability.

RESULTS: There were considerable differences between MII and results on Dx-pH: day 1 (agreement 11 out of 30, kappa 0.137) and day 2 (agreement 14 out of 30, kappa 0.036). Statistically significant differences were detected correlating all single reflux episodes (n0453) of Dx-pH with MII and vice versa. Furthermore acidic reflux episodes did not result in pH drops of the pharynx. There was a fair agreement between Dx-pH measurements on subsequent days. After follow-up, 3 out of 18 patients with pathological Dx-pH results reported positive response to PPIs, in contrast to 5 out of 6 patients with pathological MII.

CONCLUSION: According to our data, acid pharyngeal pH levels detected with Dx-pH are not related to GERD and acid esophageal reflux episodes do not result in pharyngeal pH alterations. Hence, present etiology of LPR needs to be reconsidered since neither mixed nor gas reflux events result in pharyngeal pH alteration. Other acid-producing or retaining factors should be taken into account.


Topics: pH monitoring, impedance, GI, RSI/RSF, 2012

Clinical Library

Quick access to relevant clinical news.

Here is our collection of clinical abstracts, clinician and researcher presentations and other relevant clinical news related to Restech's pH system. You will also find various research and insights covering the reflux spectrum from diagnostics to medical and surgical interventions. Stay tuned for updates!