Improving the analysis of esophageal acid exposure by a new parameter: area under H+

The American Journal of Gastroenterology
Fabrizio RebecchiMario Morino

Abstract

We aimed to compare the data provided by 24-h continuous esophageal pH monitoring in a group of patients with gastroesophageal reflux disease (GERD) to those from a group of healthy volunteers using both conventional parameters and calculated area under the curve of hydrogen ion activity (AUH+), a new value that describes the true acid exposure, through both duration and depth of acidity changes. Thirty healthy controls and 60 patients with GERD (30 symptomatic patients without endoscopic esophagitis or nonerosive GERD and 30 symptomatic patients with Savary I-IV endoscopic esophagitis or erosive GERD) were enrolled in a study based on 24-h pH monitoring to compare reference values by means of receiver operating characteristic (ROC) discriminant analysis. The best ROC cutoff value for nonerosive GERD patients was AUH+ = 103.7 (mmol/L) x min with sensitivity of 76.7% and specificity of 93.3%. The best ROC cutoff value for erosive GERD patients was AUH+ = 114.1 (mmol/L) x min with sensitivity of 100% and specificity of 96.7%. These cutoff values increase the sensitivity by 16.7% for nonerosive GERD patients and 10% for erosive GERD patients when compared to a common parameter such as the percentage of total time pH is <4 with a l...Continue Reading

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Citations

May 11, 2005·Current Medical Research and Opinion·Anthony J DiMarino, Sidney Cohen
Jun 14, 2005·Alimentary Pharmacology & Therapeutics·G L ShihD C Metz
Feb 12, 2004·Alimentary Pharmacology & Therapeutics·R TutuianP O Katz
Mar 6, 2007·The American Journal of Gastroenterology·Ikuo HiranoUNKNOWN Practice Parameters Committee of the American College of Gastroenterology
Dec 22, 2011·European Journal of Gastroenterology & Hepatology·Salman NusratKlaus Bielefeldt
Mar 28, 2008·Journal of Clinical Gastroenterology·André J P M Smout
Mar 23, 2006·The British Journal of Surgery·M MorinoF Rebecchi

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