Impact of pH Testing in Patients with Extra-Esophageal GERD Symptoms: Does Distal Esophageal Acid Exposure Predict Pharyngeal Reflux?

Reddy S, Jamal MM, Lee RH. Gastroenterology. 2013 May;144(5):S-842.


OBJECTIVES: The aims of this prospective cross sectional study were: 1) To determine the prevalence of abnormal EpH and PpH studies in patients with high Reflux Symptom Index (RSI) scores 2) To determine if parameters on EpH predict the degree of PR on PpH 3) To compare the correlation between individual PR and Esophageal Reflux (ER) events among patients with normal vs. abnormal DAE.

RESULTS: A total of 25 patients (age 53.8, 88% male, BMI 27.8, 40% with Hiatal Hernia, RSI 26.5) were studied. 32% were EpH and PpH positive, 20% EpH positive/PpH negative, 40% EpH negative/PpH positive, and 25% EpH negative/PpH negative. There was no difference in the number of PR events using any of the PpH thresholds among patients with normal vs. abnormal total DAE (Table). There were also no differences in PR events when comparing DAE in the upright or supine positions. (Table) In the analysis of individual PR events, patients with normal total DAE had a lower frequency of PR with corresponding esophageal reflux (PR+ER+) (31% vs. 57.3% p=0.002) and a higher frequency of isolated PR events (PR+ER-) (69% vs. 42.7%, p= 0.002) compared to the abnormal total DAE group (Figure 1).

CONCLUSION: A total of 25 patients (age 53.8, 88% male, BMI 27.8, 40% with Hiatal Hernia, RSI 26.5) were studied. 32% were EpH and PpH positive, 20% EpH positive/PpH negative, 40% EpH negative/PpH positive, and 25% EpH negative/PpH negative. There was no difference in the number of PR events using any of the PpH thresholds among patients with normal vs. abnormal total DAE (Table). There were also no differences in PR events when comparing DAE in the upright or supine positions. (Table) In the analysis of individual PR events, patients with normal total DAE had a lower frequency of PR with corresponding esophageal reflux (PR+ER+) (31% vs. 57.3% p=0.002) and a higher frequency of isolated PR events (PR+ER-) (69% vs. 42.7%, p= 0.002) compared to the abnormal total DAE group (Figure 1).

 

Topics: pH monitoring, predictive value, RSI/RSF, 2013

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