Combined multichannel intraluminal impedance and pH esophageal testing compared to pH alone for diagnosing both acid and weakly acidic gastroesophageal reflux

Clinical Gastroenterology and Hepatology : the Official Clinical Practice Journal of the American Gastroenterological Association
Amine HilaDonald O Castell

Abstract

Twenty-four-hour multichannel intraluminal impedance and pH (MII-pH) esophageal monitoring detects reflux episodes at all pH levels, including acid reflux and weakly acidic reflux (WAR). The aim of this study was to assess the accuracy of pH monitoring alone in detecting acid reflux and WAR compared with MII-pH. For the detection of acid reflux: 60 consecutive MII-pH studies of patients off acid suppression were included. All studies initially were read by exclusively analyzing pH tracing for acid reflux episodes. Subsequently, all studies were blindly read again analyzing MII-pH-detected acid reflux episodes (pH decrease of <4 and MII-detected reflux). For the detection of weakly acidic reflux 40 MII-pH studies were included. Each study initially was read by identifying WAR on the pH tracing. Subsequently, studies were re-analyzed using MII tracings, classifying MII-detected reflux episodes into acid, WAR, or nonacid reflux. For the detection of acid reflux the pH alone compared with MII-pH yielded a specificity of 68%, 67%, and 58%, respectively, for either abnormal percentage time of pH less than 4, positive symptom index, or both. The percentage time that the pH was less than 4 was significantly higher using pH alone compar...Continue Reading

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