Drawbacks of the Current Algorithm for Patients With Symptoms of Gastroesophageal Reflux Disease and the Impact of Adding Wireless pH Study to the Initial Diagnostic Endoscopy: Data From High-Volume Rural Antireflux Center

The American Surgeon
Medhat Y Fanous, Tyler Hughes

Abstract

Patients with symptoms of gastroesophageal reflux disease (GERD) are often given a trial of proton pump inhibitors (PPIs). When they respond, patients usually continue PPI therapy. If this empiric treatment fails, esophagogastroduodenoscopy (EGD) is recommended. When EGD findings are equivocal, pH study is warranted. We hypothesize that this algorithm results in prolonged PPI therapy, repetition of EGDs and patient dissatisfaction. This study evaluates the impact of placing a pH probe at the time of the initial EGD. IRB approval was obtained for retrospective chart review of patients who presented with GERD symptoms between August 2015 and March 2019. Patients were included if they underwent EGD with placement of wireless pH probe. A total of 379 patients (260 females, 119 males) with average age was 56.7±14.2 years. There were 253/379 (66.7%) patients who had previous EGDs (1-10). Health Satisfaction Survey was completed by 357/379 (94.2%) patients and 250/357 (70%) reported dissatisfaction with GERD control. PPI use was noted in 299/379 (78.8%) patients with average duration of 10.9±9.1 years. Testing off antisecretory medication was performed in 360/379 (94.9%). The average time interval between the clinic visit and performi...Continue Reading

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Citations

Jun 29, 2021·The American Surgeon·Medhat Y FanousSarah Williams

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Methods Mentioned

BETA
sedation

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