Development of the 24-Hour Intraesophageal pH Monitoring Composite Scoring System

Johnson, Lawrence F.; DeMeester, Tom R.

doi:10.1097/00004836-198606001-00008

Cited by 362 publications

(222 citation statements)

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“…2 Proton pump inhibitors suppress gastric acid secretion through the inhibition of H + /K + adenosine triphosphatase in gastric parietal cells. 3 Intragastric acid suppression, measured as the number of hours in a 24-hour period that intragastric pH is maintained above 4.0, is used to compare the effects of PPIs [4][5][6] and is correlated with mucosal healing rates in erosive oesophagitis. 7 Esomeprazole is the S-isomer of omeprazole and the first PPI developed as a single isomer.…”

Section: Introductionmentioning

confidence: 99%

A comparison of esomeprazole and lansoprazole for control of intragastric pH in patients with symptoms of gastro‐oesophageal reflux disease

Johnson

Stacy

Ryan

et al. 2005

Aliment Pharmacol Ther

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SUMMARYBackground: Intragastric acid suppression is the most direct measure of the pharmacodynamic efficacy of proton pump inhibitors, which are the most effective drugs for acid-related diseases. Aim: To compare the effectiveness of once and twice daily dosing of lansoprazole and esomeprazole in controlling intragastric acidity (target gastric pH > 4.0) over a 24-hour period. Methods:In an open-label, two-way crossover study, 45 Helicobacter pylori-negative patients with gastro-oesophageal reflux disease were randomized to receive one of two regimens: 30 mg lansoprazole or esomeprazole 40 mg once daily. Intragastric pH was assessed by 24-hour pH monitoring on day 5 of each regimen. Dosing was increased to twice daily and pH was reassessed on day 10. Following a 14-day washout, patients were crossed over to the other medication and the dosage regimens and pH assessments were repeated.

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Section: Introductionmentioning

confidence: 99%

A comparison of esomeprazole and lansoprazole for control of intragastric pH in patients with symptoms of gastro‐oesophageal reflux disease

Johnson

Stacy

Ryan

et al. 2005

Aliment Pharmacol Ther

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“…The analysis was based on the data provided by the distal electrode, using the table devised by Johnson and the scoring system developed by DeMeester. (14,15) Tests in which the DeMeester score was higher than 14.7 were considered abnormal.…”

Section: Resultsmentioning

confidence: 99%

“…prevalence of GERD in asthma might be due to the inclusion of cases of asthma of different complexities, as well as to the creation of study-specific parameters of normality that differ from the criteria stipulated by DeMeester. (14,15) This can lead to an underestimation of the proportion of individuals presenting asthma and GERD.…”

Section: Resultsmentioning

confidence: 99%

Esofagomanometria e pHmetria esofágica de 24 h em uma ampla amostra de pacientes com manifestações respiratórias

et al. 2008

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Objective: To determine the prevalence of gastroesophageal reflux disease (GERD) and to evaluate the esophageal motor profile of patients with respiratory symptoms referred to a digestive motility referral center for esophageal function testing. Methods: The results of esophageal manometry and 24-h esophageal pH-metry were analyzed. The inclusion criterion was presenting respiratory symptoms, with or without accompanying digestive symptoms. Results: Of the 1,170 patients included in the study, 602 (51.5%) reported having digestive and respiratory symptoms (DRS group), and 568 (48.5%) reported having only respiratory symptoms (RS group). Asthma was diagnosed in 142 patients in the RS group (RS-A subgroup) and in 201 of those in the DRS group (DRS-A subgroup). Of the 346 cases of esophageal dysmotility, hypomotility was found in 175 (14.3% and 15.6% in the DRS and RS groups, respectively), and lower esophageal sphincter (LES) hypotonia was found in 411 (40.3% and 30.2%, respectively). Hypotonia correlated with GERD. Exposure of the distal esophagus to acid was markedly abnormal in the supine position. The prevalence of GERD in the sample as a whole, the RS-A/DRS-A subgroups and the RS-A subgroup alone was 39.8%, 44.0% and 35.2%, respectively. Conclusions: Hypotonic LES was the most common abnormality and correlated with GERD. Although GERD was more evident in the DRS group, approximately one third of the patients in the RS group also presented GERD (silent GERD). The findings suggest that GERD can be an extrapulmonary cause of chronic respiratory symptoms unresponsive to conventional therapy.Keywords: Gastroesophageal reflux; Signs and symptoms, respiratory; Asthma; Esophageal pH monitoring; Manometry. ResumoObjetivo: Determinar a prevalência da doença do refluxo gastroesofágico (DRGE) e avaliar o perfil motor esofágico de portadores de manifestações respiratórias encaminhados para avaliação funcional esofágica em um serviço de referência em motilidade digestiva. Métodos: Foram analisados os resultados de esofagomanometria e de pHmetria esofágica de 24 h. O critério de inclusão foi a presença de sintomas respiratórios, acompanhados ou não de sintomas digestivos. Resultados: Dos 1.170 pacientes incluídos no estudo, 602 (51,5%) relataram manifestações digestivas associadas às respiratórias (grupo MRD) e 568 (48,5%), apenas respiratórias (grupo MR). A asma foi diagnosticada em 142 indivíduos no grupo MR (subgrupo MR-A) e em 201 no grupo MRD (subgrupo MRD-A). Dentre os 346 casos de dismotilidade do corpo esofágico, a hipomotilidade esteve presente em 175 (14,3% e 15,6%, respectivamente, no grupos MRD e MR) e hipotonia do esfíncter esofágico inferior (EEI) em 411 (40.3% e 30,2% nos mesmos grupos, respectivamente). A hipotonia se correlacionou com DRGE. A exposição do esôfago distal ao ácido foi marcadamente anormal no período de decúbito. A prevalência de DRGE na amostra total, nos subgrupos MR-A/MRD-A e somente no subgrupo MR-A foi de 39,8%, 44,0% e 35,2%, respectivamente. Conclusões: A hipotonia do EEI foi a ...

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“…Compared to the nasopharyngeal catheter system, the wireless capsule is cosmetically more acceptable to most patients, as it is attached to the lower oesophageal mucosa and allows for a longer duration of monitoring of up to 48 hours. Based on normal values that were previously published for the 24-hour nasopharyngeal catheter system (38) and wireless Bravo capsule, (39) we can objectively quantify oesophageal acid exposure (usually expressed as the percentage of time during which pH < 4). GERD is diagnosed in the presence of an elevated oeosphageal acid exposure time.…”

Section: Oesophageal Ph Monitoringmentioning

confidence: 99%

Persistent gastro-oesophageal reflux symptoms despite proton pump inhibitor therapy

Ang

How

2016

smedj

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Development of the 24-Hour Intraesophageal pH Monitoring Composite Scoring System

Cited by 362 publications

References 0 publications

A comparison of esomeprazole and lansoprazole for control of intragastric pH in patients with symptoms of gastro‐oesophageal reflux disease

A comparison of esomeprazole and lansoprazole for control of intragastric pH in patients with symptoms of gastro‐oesophageal reflux disease

Esofagomanometria e pHmetria esofágica de 24 h em uma ampla amostra de pacientes com manifestações respiratórias

Persistent gastro-oesophageal reflux symptoms despite proton pump inhibitor therapy

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