Potentials of intraesophageal рН-impedance measurement in GERD diagnostics
Abstract
The aim of review. To demonstrate potentials and advantage of new method of gastroesophageal reflux disease (GERD) diagnostics – esophageal рН-impedance measurement.
Key points. рН-impedance measurement of the esophagus allows to identify reflux episodes in the esophagus irrespective of refluxate рН. In contrast to traditional pH-metry the new method represents physical state of refluxate (gas, fluid, mixed contents), time of volume clearance to determine relation of observed symptoms to non-acidic refluxes. This promotes improvement of diagnostics and treatment of GERD.
Conclusion. Application of esophageal рН-impedance measurement allows to consider this method as the most exact and modern in diagnostics of GERD.
About the Authors
V. O. KaybyshevaRussian Federation
O. A. Storonova
Russian Federation
A. S. Trukhmanov
Russian Federation
V. T. Ivashkin
Russian Federation
References
1. Гриневич В.Б. Мониторинг рН, желчи и импедансмониторинг в диагностике ГЭРБ // Эксперим. клин. гастроэнтерол. – 2004. – № 6. – С. 119–121.
2. Ивашкин В.Т., Маев И.В., Трухманов А.С. Пищевод Баррета. – М.: Шико, 2011. – С. 447–449.
3. Маев И.В., Вьючинова Е.С., Щекина М.И. Гастроэзофагеальная рефлюксная болезнь – болезнь XXI века // Лечащий врач. – 2004. – № 4. – С. 10–14.
4. Blom D., Mason R.J., Balaji N.S. et al. Esophageal bolus transport identified by simultaneous multichannel intraluminal impedance and manofluoroscopy // Gastroenterology. – 2001. – Vol. 120 – P. 103. [Abstract].
5. Bredenoord A.J., Tutuian R. et al. Technology Review: Esophageal Impedance Monitoring // Am. J. Gastroenterol. – 2007. – Vol. 102. – P. 187–194.
6. Bredenoord A.J., Weusten B.L., Sifrim D. et al. Aerophagia, gastric, and supragastric belching: a study using intraluminal electrical impedance monitoring // Gut. – 2004. – Vol. 53, N 11. – P. 1561–1565.
7. Fass J., Silny J., Braun J. et al. Measuring esophageal motility with a new intraluminal impedance device. First clinical results in reflux patients // Scand. J. Gastroenterol. – 1994. – Vol. 29. – P. 693–702.
8. Kahrilas P., Shaheen N., Vaezi M. American Gastroenterological Association Institute Technical Review on the Management of Gastroesophageal Reflux Disease // Gastroenterology. – 2008. – Vol. 135. – P. 1392–1413.
9. Mainie I., Tutuian R., Shay S. et al. Acid and nonacid reflux in patients with persistent symptoms despite acid suppressive therapy. A multicentre study using combined ambulatory impedance-pH monitoring // Gut. – 2006. doi:10.1136/gut.2005. 087668.
10. Shay S., Richter J. Direct comparison of impedance, manometry, and pH probe in detecting reflux before and after a meal // Dig. Dis. Sci. – 2005. – Vol. 50, N 9. – P. 1584–1590.
11. Shay S., Tutuian R., Sifrim D. et al. Twenty-four hour ambulatory simultaneous impedance and pH monitoring: a multicenter report of normal values from 60 healthy volunteers // Am. J. Gastroenterol. – 2004. – Vol. 99. – P. 1037–1043.
12. Sifrim D., Castell D., Dent J. et al. Gastroesophageal reflux monitoring: Review and consensus report on detection and definitions of acid, non-acid, and gas reflux // Gut. – 2004. – Vol. 53. – P. 1024–1031.
13. Sifrim D., Dupont L., Blondeau K. et al. Weakly acidic reflux in patients with chronic unexplained cough during 24-hour pressure, pH, and impedance monitoring // Gut. – 2005. – Vol. 54. – P. 449–454.
14. Sifrim D., Holloway R.H., Silny J. et al. Non-acid gastroesophageal reflux // Gastroenterology. – 2001. – Vol. 120 – P. 436. [Abstract].
15. Silny J. Intraluminal multiple electric impedance procedure for measurement of gastrointestinal motility // J. Gastrointest. Motil. – 1991. – Vol. 3. – P. 151–162.
16. Silny J., Knigge K.P., Fass J. et al. Verification of the intraluminal multiple electrical impedance measurement for recording of gastrointestinal motility // J. Gastrointest. Motil. – 1993. – Vol. 5. – P. 107–122.
17. Simren M., Silny J., Holloway R. et al. Relevance of ineffective oesophageal motility during oesophageal acid clearance // Gut. – 2003. – Vol. 52. – P. 784–790.
18. Tutuian R., Castell D. Clinical Application of ImpedanceManometry for Motility Testing and Impedance-pH for Reflux Monitoring // Clin. Gastroenterol. Hepatol. – 2005. – Vol. 2. – P. 230–236.
19. Tutuian R., Castell D. Rumination documented by using combined multichannel intraluminal impedance and manometry // Clin. Gastroenterol. Hepatol. – 2004. – Vol. 2, N 4. – P. 340–343.
20. Vela M.F., Camacho-Lobato L., Srinivasan R. et al. Simultaneous intraesophageal impedance and pH measurement of acid and nonacid gastroesophageal reflux: Effect of omeprazole // Gastroenterology. – 2001. – Vol. 120. – P. 1599–1606.
21. Zerbib F., des Varannes S.B., Roman S. et al. Normal values and day-to-day variability of 24-h ambulatory oesophageal impedance-pH monitoring in a BelgianFrench cohort of healthy subjects // Aliment. Pharmacol. Ther. – 2005. – Vol. 22. – P. 1011–1032.
22. Zerbib F., Roman S., Ropert A. et al. Esophageal pH-impedance monitoring and symptom analysis in GERD: a study in patients off and on therapy // Am. J. Gastroenterol. – 2006. – Vol. 101. – P. 1956–1963.
Review
For citations:
Kaybysheva V.O., Storonova O.A., Trukhmanov A.S., Ivashkin V.T. Potentials of intraesophageal рН-impedance measurement in GERD diagnostics. Russian Journal of Gastroenterology, Hepatology, Coloproctology. 2013;23(2):4-16. (In Russ.)