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• W2977774311 abstract "Purpose: 24 hour esophageal pH testing (pH) has been the gold standard for the evaluation of suspected gastroesophageal reflux disease (GERD). Recent advances in technology now allow detection of acid and non-acid GERD by combining multichannel intraluminal impedance and 24 hour pH testing (MII-pH). Aim: To determine whether patients in a community setting with persistent symptoms suggestive of GERD while on high dose acid suppression should be evaluated by MII-pH on or off high dose acid suppression. Methods: Charts were reviewed from patients who continued to have symptoms suggestive of GERD while on high dose acid suppression who had been studied by MII-pH either on high dose acid suppression or after medication discontinuation. High dose acid suppression consisted of full strength proton pump inhibitor twice daily plus 300 mg of bedtime ranitidine (PPI/H2Rx). Results were analyzed to see if MII-pH added information beyond pH that would alter management. Added information included: 1) no acid or non-acid reflux; 2) non-acid reflux; 3) an explanation of symptoms; 4) acid and non-acid reflux. Groups were compared by Chi Square. Sensitivity analysis was determined between pH and MII-pH for patients off medication. Results: 82 patients (31 PPI/H2Rx; 51 no acid suppression) were studied. 29/31 (93.5%) revealed added information with PPI/H2Rx compared to 39/51 (76.5%) with no acid suppression. Conversely, 2/31 (93.5%) with PPI/H2Rx derived no additional information beyond pH compared to 12/51 (23.5%) with no acid suppression. These differences were statistically significant (p < 0.05 by Chi Square). 14/51 (27%) patients off treatment had abnormal MII-pH with negative pH tests. Assuming no false positive results for pH, and MII-pH is a more informative test, the sensitivity is 67%, specificity is 100%, positive predictive value is 100% and negative predictive value is 36% for pH testing vs. MII-pH testing off therapy. Conclusions: 1) In the community setting, patients should be tested on high dose acid therapy when undergoing MII-pH for suspected GERD with continuing symptoms on therapy; 2) MII-pH provides information beyond pH that alters patient care; 3) MII-pH testing should be considered the new gold standard for GERD testing in the community; 4) Further prospective studies are needed to confirm this initial investigation finding." @default.
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• W2977774311 date "2006-09-01" @default.
• W2977774311 modified "2023-09-25" @default.
• W2977774311 title "Multichannel Intraluminal Impedance and 24 Hour pH Testing in the Community Setting" @default.
• W2977774311 doi "https://doi.org/10.14309/00000434-200609001-00028" @default.
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