Comparison of the Bravotm Wireless and Digitrappertm Catheter-Based pH Monitoring Systems for Measuring Esophageal Acid Exposure

Pandolfino, John E.; Schreiner, Mitchal A.; Lee, Thomas J.; Zhang, Qing; Boniquit, Christopher; Kahrilas, Peter J.

doi:10.1111/j.1572-0241.2005.41719.x

Cited by 83 publications

(89 citation statements)

References 8 publications

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“…Initial screening assessment was conducted without discontinuation of PPIs and consisted of the nine-question GERD health-related quality-of-life (GERD-HRQL) [22], 24-hour ambulatory pH-metry [23,24], upper GI endoscopy, esophageal biopsy, esophageal manometry, medical history, and GERD medication usage as described previously [19,20]. In addition, we assessed each patient's ability to consume foods and beverages commonly associated with triggering GERD symptoms, such as citrus, strawberries, tomatoes, chocolate, fatty foods, deep-fried foods, spicy foods, carbonated drinks, tea, coffee, caffeinated drinks, and alcohol [25].…”

Section: Methodsmentioning

confidence: 99%

“…Patients (n = 14, 50% female) available at 2 years had a median age of 34 (range, 23-55) years and a median BMI of 22 (18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31) kg/m 2 . Patients had suffered from GERD for a median of 10 (range, 3-15) years and were on continuous daily PPI therapy for a median of 6 (range, 2-13) years before undergoing TIF.…”

Section: Patient Characteristicsmentioning

confidence: 99%

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Two-year results of a feasibility study on antireflux transoral incisionless fundoplication using EsophyX

et al. 2009

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Background A feasibility study (n = 19) evaluated the safety and initial efficacy of transoral incisionless fundoplication (TIF) for the treatment of gastroesophageal disease (GERD). The results at 1 year (n = 17) indicated that TIF was safe and had a significant effect on reducing GERD symptoms, proton pump inhibitor (PPI) usage, acid exposure, and small hiatal hernia. This study was designed to evaluate the long-term safety and durability of TIF. Methods Fourteen patients (50% female; median age, 34 years) completed the 2-year follow-up assessment tests. Three patients were excluded from the study after 1 year because two of them underwent retreatment and one was lost to follow-up. Results At 2 years, no adverse events related to TIF were reported. A C50% improvement in GERD-HRQL scores compared with those at baseline on PPIs was sustained by 64% of patients. TIF was effective in eliminating heartburn in 93% of patients and daily PPI therapy in 71% of patients. Significantly (p \ 0.05) more patients were able to consume reflux-causing foods and maintain lifestyle activities without GERD symptoms compared with baseline on PPIs. Fundoplications were durable and maintained their geometric dimensions. TIF was effective in eliminating hiatal hernia in 60% of patients and esophagitis in 55% of patients. Global assessment of all outcomes in each patient revealed that 79% of patients experienced complete cure (29%) or remission (50%) of GERD at 2 years after TIF. Conclusion The results at 2 years supported the longterm safety and durability of TIF and its sustained effect on the elimination of heartburn, esophagitis, B2 cm hiatal hernia, and daily dependence on PPIs.

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Section: Methodsmentioning

confidence: 99%

Section: Patient Characteristicsmentioning

confidence: 99%

Two-year results of a feasibility study on antireflux transoral incisionless fundoplication using EsophyX

et al. 2009

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“…The endoclip method has been used to quantify EGJ mobility in the setting of primary peristalsis [10,13], secondary peristalsis [11], transient LES relaxation [12] and pH electrode placement [14]. With each of these conditions, longitudinal muscle contraction leads to esophageal shortening which leads to stretch of the phrenoesophageal membrane and displacement of the EGJ through the hiatus.…”

Section: Mobility Of the Esophagogastric Junctionmentioning

confidence: 99%

Approaches to the diagnosis and grading of hiatal hernia

Kahrilas

Kim

Pandolfino

2008

Best Practice & Research Clinical Gastroenterology

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386

248

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Hiatus hernia refers to conditions in which elements of the abdominal cavity, most commonly the stomach, herniate through the esophageal hiatus into the mediastinum. With the most common type (type I or sliding hiatus hernia) this is associated with laxity of the phrenoesophageal membrane and the gastric cardia herniates. Sliding hiatus hernia is readily diagnosed by barium swallow radiography, endoscopy, or manometry when greater than 2 cm in axial span. However, the mobility of the esophagogastric junction precludes the reliable detection of more subtle disruption by endoscopy or radiography. Detecting lesser degrees of axial separation between the lower esophageal sphincter and crural diaphragm can only be reliably accomplished with high resolution manometry, a technique that permits real time localization of these esophagogastric junction components without swallow or distention related artifact.

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“…The receiver hardware is also checked to confirm proper data transmission. 14 The carrier frequency of the pH signal is in the 433-MHz band. 12 Digital data transmission occurs every 12 seconds with 2 pH data-points obtained every 6 seconds.…”

Section: Test Equipmentmentioning

confidence: 99%

“…15 With conventional endoscopic guidance, the gastroesophageal junction (GEJ) is identified, followed by removal of endoscope and then the capsule is placed 6 cm proximal to the GEJ. 12,14 This position is derived from observation that the high pressure zone of lower esophageal sphincter (LES) is typically 1 to 1.5 cm proximal to the GEJ. With direct endoscopic guidance, the endoscope is left in place within the esophagus while the Bravo delivery system is being deployed and capsule placed under direct view of the endoscope.…”

Section: Test Proceduresmentioning

confidence: 99%

Evaluation of Gastroesophageal Reflux Disease Using the Bravo Capsule pH System

Lawenko

Lee

2015

J Neurogastroenterol Motil

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Gastroesophageal reflux disease (GERD) is a disease predominantly seen in the West but there is a rising trend in Asia. Ambulatory 24-hour catheter-based pH monitoring has been the de facto gold standard test for GERD that correlates symptoms with acid reflux episodes. However, drawbacks such as patients' discomfort, and catheter displacement render the test as cumbersome and errorprone. The Bravo pH wireless system is designed to be user-friendly and has an added advantage of prolonged pH monitoring. The system is comparable to the catheter-based pH monitoring system in terms of diagnostic yield and symptom-reflux association. Indications include evaluation of patients with refractory GERD symptoms and prior to anti-reflux surgery. Bravo utilizes a wireless pH-sensing capsule with a complete prepackaged system, and a data processing software. The capsule may be positioned indirectly using endoscopic or manometric landmarks or under direct endoscopic guidance. Optimal threshold cut-off values are yet to be standardized but based on available studies, for the Asian population, it may be recommended for total % time pH < 4 of 5.8 over 48 hours. Cost is a limitation but capsule placement is relatively safe although technical failures may be seen in small percentage of cases.

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Comparison of the Bravotm Wireless and Digitrappertm Catheter-Based pH Monitoring Systems for Measuring Esophageal Acid Exposure

Cited by 83 publications

References 8 publications

Two-year results of a feasibility study on antireflux transoral incisionless fundoplication using EsophyX

Two-year results of a feasibility study on antireflux transoral incisionless fundoplication using EsophyX

Approaches to the diagnosis and grading of hiatal hernia

Evaluation of Gastroesophageal Reflux Disease Using the Bravo Capsule pH System

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