Optimization of impedance-measured reflux events in GORD utilizing acid exposure time.

BMC Gastroenterology
Anthony J Horton, Steven B Clayton

Abstract

Combining impedance with pH monitoring improves the detection and characterization of gastro-oesophageal reflux (GOR), yet the two modalities frequently differ in GOR quantification. Ambulatory 24-h pH-impedance monitoring often reveals more significant oesophageal acid exposure than impedance-measured reflux activity in patients with symptomatic gastro-oesophageal reflux disease (GORD). The purpose of this study is to elucidate the discrepancies between these modalities by assessing the predictive accuracy of impedance compared to acid exposure standards. A single-institution, retrospective review of sequential 24-h pH-impedance results of 72 patients with symptomatic GOR off anti-secretory therapy was conducted. Reflux events measured by impedance were stratified by patient position and compared to oesophageal acid exposure time (AET). Oesophageal AET limits for GORD detection were utilized as gold standards to generate serial receiver operator characteristics (ROC) curves to assess the sensitivity and specificity of current impedance GORD detection limits and identify optimized impedance standards based on area under the curve (AUC) analysis. Mean total AET time was 10.5% (± 9.9%), and 63.8% of patients had elevated AET. By ...Continue Reading

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Citations

Dec 31, 2020·Neurogastroenterology and Motility : the Official Journal of the European Gastrointestinal Motility Society·Seung Young KimHye Ah Lee

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