Ambulatory pH Measurements at the Upper Esophageal Sphincter

Smit, Conrad F.; Tan, Joep; Devriese, P. P.; Mathus-Vliegen, Lisbeth; Brandsen, Marc; Schouwenburg, Paul F.

doi:10.1097/00005537-199802000-00027

Cited by 98 publications

(105 citation statements)

References 6 publications

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“…The latter known as pseudo-reflux events, represent a technical "failure", usually of the electrode and are related to oxidation, desiccation processes or blockage due to mucus or refluxed material. They usually take place at night and are characterised by a drop in pH in the upper oesophagus independently of the presence of acid in the lower oesophagus (9,11) (Fig. 1).…”

Section: Discussionmentioning

confidence: 99%

“…For the study of patients with extra-oesophageal syndromes, different placements of the pH electrode have been employed: upper oesophagus (11,19,20), UOS (6,9), trachea (21,22), pharynx (5.11,23,24), oropharynx (25) or simultaneously in the upper oesophagus and pharynx (26), considering that for an improved assessment, the proximal pH electrode should be placed as close as possible to the organ in question (larynx or pharynx) (9,24). To date no comparisons have been established in this respect in normal subjects (11,23,24) but in those with laryngitis (27).…”

Section: Discussionmentioning

confidence: 99%

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Normal values in ambulatory oesophageal pH monitoring at two levels in Spain

Digestiva¹,

Azpiroz²,

Baudet³

et al. 2010

Rev. esp. enferm. dig.

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Aim: upper oesophageal pH monitoring may play a significant role in the study of extra-oesophageal GERD, but limited normal data are available to date. Our aim was to develop a large series of normal values of proximal oesophageal acidification.Methods: 155 healthy volunteers (74 male) participated in a multi-centre national study including oesophageal manometry and 24 hours oesophageal pH monitoring using two electrodes individually located 5 cm above the LOS and 3 cm below the UOS.Results: 130 participants with normal manometry completed all the study. Twelve of them were excluded for inadequate pH tests. Twenty-seven subjects had abnormal conventional pH. The remaining 91 subjects (37 M; 18-72 yrs age range) formed the reference group for normality. At the level of the upper oesophagus, the 95 th percentile of the total number of reflux events was 30, after eliminating the meal periods 22, and after eliminating also the pseudo-reflux events 18. Duration of the longest episodes was 5, 4 and 4 min, respectively (3.5 min in upright and 0.5 min in supine). The upper limit for the percentage of acid exposure time was 1.35, 1.05 and 0.95%, respectively. No reflux events were recorded in the upper oesophagus in 8 cases.Conclusion: this is the largest series of normal values of proximal oesophageal reflux that confirm the existence of acid reflux at that level in healthy subjects, in small quantity and unrelated to age or gender. Our data support the convenience of excluding pseudo-reflux events and meal periods from analysis.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Normal values in ambulatory oesophageal pH monitoring at two levels in Spain

Digestiva¹,

Azpiroz²,

Baudet³

et al. 2010

Rev. esp. enferm. dig.

View full text Add to dashboard Cite

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“…Acid exposure in the hypopharynx can easily be missed because of the relatively large space within the hypopharynx [15] . On the contrary, placement of the proximal probe in or below the upper esophageal sphincter allows for more permanent contact with the mucosa during the 24-h period and this results in fewer artifacts [15,16] . We used a dual-site pH probe with electrodes placed at the tip and 15 cm proximal to the tip, and we could not choose the exact location of the proximal probe.…”

Section: Discussionmentioning

confidence: 99%

“…Yet in most cases (75.4%, 346/459), the proximal probe was located in the UES. So, for the diagnosis of GPRD, we used the criteria proposed by Smit et al [15,16] . Why is IEM not associated with GPRD as well as GERD?…”

Section: Discussionmentioning

confidence: 99%

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Is ineffective esophageal motility associated with gastropharyngeal reflux disease?

Kim

Kim²,

Kim³

et al. 2008

WJG

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AIM:To evaluate the association between ineffective esophageal motility (IEM) and gastropharyngeal reflux disease (GPRD) in patients who underwent ambulatory 24-h dual-probe pH monitoring for the evaluation of supraesophageal symptoms. METHODS: A total of 632 patients who underwent endoscopy, esophageal manometry and ambulatory 24-h dual-pH monitoring due to supraesophageal symptoms (e.g. globus, hoarseness, or cough) were enrolled. Of them, we selected the patients who had normal esophageal motility and IEM. The endoscopy and ambulatory pH monitoring findings were compared between the two groups. RESULTS: A total of 264 patients with normal esophageal motility and 195 patients with the diagnosis of IEM were included in this study. There was no difference in the frequency of reflux esophagitis and hiatal hernia between the two groups. All the variables showing gastroesophageal reflux and gastropharyngeal reflux were not different between the two groups.

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