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The added diagnostic value of postreflux swallow-induced peristaltic wave index and nocturnal baseline impedance in refractory reflux disease studied with on-therapy impedance-pH monitoring
- Publication Year :
- 2016
- Publisher :
- Blackwell Publishing Ltd, 2016.
-
Abstract
- Background: On-therapy impedance-pH monitoring in proton pump inhibitor (PPI)-refractory gastroesophageal reflux disease (GERD) yielded conflicting results. We aimed to assess the diagnostic value of postreflux swallow-induced peristaltic wave (PSPW) index and mean nocturnal baseline impedance (MNBI) in PPI-refractory heartburn. Methods: On-therapy impedance-pH tracings from 189 consecutive patients with PPI-refractory heartburn were blindly reviewed. Patients were subdivided into refractory reflux esophagitis (RRE), healed reflux esophagitis (HRE), non-erosive reflux disease (NERD), and functional heartburn (FH) according to endoscopic and conventional impedance-pH findings. The diagnostic accuracy of PSPW index and MNBI in separating NERD from FH was assessed with receiver-operating-characteristic (ROC) analysis. Objectively documented persistent reflux remission at 3-year follow-up in 53 patients who underwent laparoscopic fundoplication served to evaluate PSPW index and MNBI as independent predictors of PPI-refractory GERD confirmed by positive surgical outcome. Key Results: Median PSPW index and MNBI values were significantly lower in 39 RRE (16%; 1145Ω) than in 41 HRE (25%; 1741Ω) and in 68 NERD (29%; 2374Ω) patients, and in all three GERD subgroups compared to 41 FH cases (67%; 3488Ω) (P
- Subjects :
- Adult
Male
Impedance–pH monitoring
medicine.medical_specialty
Esophageal baseline impedance
Esophageal chemical clearance
Impedance-pH monitoring
Refractory GERD
Physiology
Endocrine and Autonomic Systems
Gastroenterology
Esophageal pH Monitoring
medicine.drug_class
Nerd
Peristalsi
Proton-pump inhibitor
Endocrine and Autonomic System
03 medical and health sciences
esophageal baseline impedance
esophageal chemical clearance
impedance-pH monitoring
refractory GERD
0302 clinical medicine
Heartburn
Retrospective Studie
Internal medicine
Electric Impedance
Humans
Medicine
Reflux esophagitis
Retrospective Studies
business.industry
Area under the curve
Reflux
Middle Aged
medicine.disease
digestive system diseases
Deglutition
030220 oncology & carcinogenesis
Gastroesophageal Reflux
GERD
Peristalsis
Female
030211 gastroenterology & hepatology
medicine.symptom
business
Human
Subjects
Details
- Language :
- English
- Database :
- OpenAIRE
- Accession number :
- edsair.doi.dedup.....dab8fa133c79775c84bf3fd8f80556c5