Intrapharyngeal Distribution of Gastric Acid Refluxate

Shaker, Reza; Bardan, Eytan; Gu, Chengming; Kern, Mark; Torrico, Laura; Toohill, Robert J.

doi:10.1097/00005537-200307000-00014

Cited by 54 publications

(48 citation statements)

References 17 publications

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“…In our study, 24-h monitoring of pH in the proximal esophagus did not provide any additive information and may be regarded of little value. This has also been stated by others [12, 22, 23]. Another shortcoming of pH-metry is the fact that this method can only detect acidic reflux but not non- or weakly acidic reflux episodes; furthermore, it has to be stated that dual-channel pH-metry may also be inaccurate due to the difficult placement of the proximal pH sensor in patients with shortened esophagi [28].…”

Section: Discussionmentioning

confidence: 80%

Combined pH-Metry/Impedance Monitoring Increases the Diagnostic Yield in Patients with Atypical Gastroesophageal Reflux Symptoms

et al. 2007

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Background: Globus sensations, hoarseness and chronic cough are suggested to be atypical manifestations of Gastroesophageal Reflux Disease (GERD). The aim of the study was to investigate whether combined pH-metry and multichannel intraluminal impedance monitoring increases the diagnostic yield. Methods: 41 patients with atypical GERD symptoms were included in the study. Globus sensation was the dominant symptom in 23 patients (56.1%). The remaining 18 patients (43.9%) complained mainly about hoarseness or chronic cough. All patients were examined by endoscopy, dual-channel pH-metry and impedance monitoring off-therapy with proton pump inhibitors (PPI). Diagnostic yield of the respective method was determined. Results: A total of 26 patients (63.4%) had pathological findings in any method. The highest diagnostic yield was achieved by combined 24-h pH-metry/impedance measurement (61.0%), followed by solely impedance measurement (48.8%), distal pH-metry (29.3%), endoscopy (22.8%) and proximal pH-metry (17.1%). All patients with a positive PPI-test and 25% of patients (5/20) with a negative PPI-test had a pathological result in pH-metry/impedance. Conclusion: Multichannel intraluminal impedance monitoring increases the diagnostic yield for objective detection of atypical manifestation of GERD. Combined 24-h pH-metry/impedance measurement has the best diagnostic yield for detection of gastroesophageal reflux and has therefore the potential to represent a new diagnostic gold standard.

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Section: Discussionmentioning

confidence: 80%

Combined pH-Metry/Impedance Monitoring Increases the Diagnostic Yield in Patients with Atypical Gastroesophageal Reflux Symptoms

et al. 2007

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“…Whereas several previous normative studies of ambulatory 24-h pH pharyngeal monitoring were all carried out in Western countries, the present study is the first report of an Asian cohort and provides needed information on normal values that can be used as a reference for pharyngeal pH monitoring [2,[17][18][19][20][21][22][23][24].…”

Section: Discussionmentioning

confidence: 94%

“…[2,[17][18][19][20][21][22][23][24]. The possibility of obtaining misinformation might have existed if only a subjective evaluation tool was used to select healthy subjects.…”

Section: Discussionmentioning

confidence: 99%

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Ambulatory 24-Hour Pharyngeal pH Monitoring in Healthy Korean Volunteers

Moon

Park

et al. 2009

Dig Dis Sci

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Pharyngeal pH monitoring is the standard diagnostic approach for laryngopharyngeal reflux (LPR). However, the normal values for Asian populations are still unknown. We evaluated the results of ambulatory 24-h pharyngeal pH monitoring in healthy volunteers to determine the normal reference values in the Korean population. Thirty healthy subjects underwent ambulatory 24-h pharyngeal pH monitoring with glass electrodes positioned 1 cm above the upper esophageal sphincter and 5 cm above the lower esophageal sphincter, based on esophageal manometry after upper gastrointestinal endoscopy. LPR occurred in about one half of the healthy volunteers without any significant association with age, gender and body mass index. Pharyngeal acid reflux occurred mainly in the upright position. At the 95th and 90th percentile, after the exclusion of mealtimes, the upper limits of normal (ULN) for pharyngeal acid exposure were 0.41% and 0.18%. The ULNs for the number of pharyngeal acid events were 12.8 and 5.0. The corresponding ULNs for the esophagus were 5.1% and 3.8% and 62.7 and 32.6. The findings of this study help establish the reference standards for LPR in Korean patients.

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“…10 The most distinct changes induced by supraesophageal reflux occur in the larynx, making laryngologic examination an important tool in the diagnosis of LPR. 5,11 Laryngoscopy is the first-line investigation method that is usually performed to make a diagnosis of LPR.…”

Section: Discussionmentioning

confidence: 99%

Interrater Reliability among Endoscopists: Diagnosis of Laryngopharyngeal Reflux Based on the Reflux Finding Score Determined by Upper Endoscopy

Lee

Bang

Kim

et al. 2017

Korean J Helicobacter Up Gastrointest Res

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Background/Aims: Laryngopharyngeal reflux (LPR) is an extraesophageal manifestation of gastroesophageal reflux disease. Endoscopic assessment of LPR is needed for convenient diagnosis and documentation of treatment efficacy. The aim of this study was to investigate the interrater reliability of LPR among endoscopists based on endoscopic laryngeal images. Materials and Methods: Nineteen endoscopists participated in this study. Before the test, they completed an intensive education program by an otorhinolaryngologist on the reflux finding score (RFS), which is a validated laryngoscopic assessment of LPR. A total of 100 endoscopic laryngeal images were used for 3 tests of RFS. Cohen's and Fleiss' kappa coefficients were used to determine the degree of interrater agreement in the diagnosis of LPR. Results: In the first test, the mean of Cohen's kappa coefficients for LPR diagnosis between the otorhinolaryngologist and each of the 19 endoscopists was 0.3. In the second test, after additional education, the mean kappa value was 0.32.

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Intrapharyngeal Distribution of Gastric Acid Refluxate

Cited by 54 publications

References 17 publications

Combined pH-Metry/Impedance Monitoring Increases the Diagnostic Yield in Patients with Atypical Gastroesophageal Reflux Symptoms

Combined pH-Metry/Impedance Monitoring Increases the Diagnostic Yield in Patients with Atypical Gastroesophageal Reflux Symptoms

Ambulatory 24-Hour Pharyngeal pH Monitoring in Healthy Korean Volunteers

Interrater Reliability among Endoscopists: Diagnosis of Laryngopharyngeal Reflux Based on the Reflux Finding Score Determined by Upper Endoscopy

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