Limitations of 24-hour intraesophageal pH monitoring in the hospital setting

Schlesinger, Paul K.; Donahue, Philip E.; Schmid, B.; Layden, Thomas J.

doi:10.1016/0016-5085(85)90575-x

Cited by 141 publications

(50 citation statements)

References 20 publications

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“…Some additional papers have provided cause for concern. Normal acid exposure was reported in as many as 29% of patients with documented esophagitis and differences were found in the simultaneous acid exposure recorded by two attached probes (23,24). Despite these limitations, ambulatory pH testing remains the best method to study the actual amount of reflux occurring in a given patient.…”

Section: Endoscopy In Gerdmentioning

confidence: 99%

Updated guidelines for the diagnosis and treatment of gastroesophageal reflux disease

DeVault¹

1999

The American Journal of Gastroenterology

143

178

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PREAMBLEGuidelines for the diagnosis and treatment of gastroesophageal reflux disease (GERD) were published by the American College of Gastroenterology in 1995 (1). These and other guidelines undergo periodic review. Significant advances have been made in the area of GERD over the past several years, leading us to review and revise our previous guidelines statements. These advances have included an increase in our comfort with the chronic use of proton pump inhibitors and an increased acceptance of laparoscopic antireflux surgery, among other factors. These and the original guidelines are intended to apply to all physicians who address GERD and are intended to indicate the preferable, but not only acceptable, approach. Physicians must always choose the course best suited to the individual patient and the variables that exist at the moment of the decision. These guidelines are intended to apply to adult patients with the symptoms, tissue damage, or both that result from the reflux of gastric contents into the esophagus. For the purpose of these guidelines GERD is defined as chronic symptoms or mucosal damage produced by the abnormal reflux of gastric contents into the esophagus.Both these and the original guidelines were developed under the auspices of the American College of Gastroenterology and its Practice Parameters Committee, and approved by the Board of Trustees. The world literature was reviewed extensively for the original guidelines and was once again reviewed using the National Library of Medicine database. All appropriate studies were reviewed and any additional studies found in the reference list of these papers were obtained and reviewed. Evidence was evaluated along a hierarchy, with randomized controlled trials given the greatest weight. Abstracts presented at national and international meetings were only used when unique data from ongoing trials were presented. When scientific data were lacking, recommendations were based on expert consensus. During preparation, the guidelines were reviewed

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Section: Endoscopy In Gerdmentioning

confidence: 99%

Updated guidelines for the diagnosis and treatment of gastroesophageal reflux disease

DeVault¹

1999

The American Journal of Gastroenterology

143

178

View full text Add to dashboard Cite

show abstract

“…Good reproducibility (84-93%) and sensitivity and specificity (96%) have been reported in patients with erosive esophagitis (30,31). Reasons for concern include the finding of normal acid exposure in up to 29% of patients with documented esophagitis and differences found in the simultaneous acid exposure recorded by two attached probes (32,33). A recent report repeated pH testing on patients who had an initial negative test (34).…”

Section: Level Of Evidence: IIImentioning

confidence: 99%

Updated Guidelines for the Diagnosis and Treatment of Gastroesophageal Reflux Disease

DeVault

Castell

2005

Am J Gastroenterology

799

493

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“…[14][15][16][17][18] Despite the lack of evidence in its favor, gastroenterologists may be willing to try empiric dilation in patients with non-obstructive dysphagia, because esophageal dilation is generally a safe procedure and easy to perform in the absence of stricture. Gastroenterologists may perform empiric dilations under the assumption that they are treating subtle symptomatic strictures that are endoscopically undetectable.…”

Section: Discussionmentioning

confidence: 99%

Empiric Dilation in Non-obstructive Dysphagia

2007

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Aims-To study practice patterns in the management of non-obstructive dysphagia among US gastroenterologists.Data source-Endoscopic data repository from 100 U.S. gastroenterology practices during 1998-2003. between 1998 and 2003 (n=181,261) were evaluated for demographic data, endoscopic findings, and the occurrence of esophageal dilation. A case population of 7,256 patients receiving empiric dilation for dysphagia for non-obstructive dysphagia was compared to a control population of 5,764 patients with dilation for peptic strictures. Methods-All initial EGDs in adult patientsResults-The group of patients with empiric dilation was younger than the group of patients with peptic strictures and contained more women. Reflux symptoms and erosive esophagitis were less frequent in the empiric dilation than in the strictures group. Empiric dilations were mostly performed using rubber bougies, whereas strictures were most frequently dilated over a guidewire. For all types of dilators, the diameters were significantly larger in empiric than stricture dilation. Repeat dilations within one year after the initial procedure occurred in 4% of the empiric and 13% of the stricture dilations.Conclusions-Compared with dilation of peptic strictures, empiric dilation of non-obstructive dysphagia is a more common clinical practice that is performed in a different patient population and utilizes different techniques.

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Limitations of 24-hour intraesophageal pH monitoring in the hospital setting

Cited by 141 publications

References 20 publications

Updated guidelines for the diagnosis and treatment of gastroesophageal reflux disease

Updated guidelines for the diagnosis and treatment of gastroesophageal reflux disease

Updated Guidelines for the Diagnosis and Treatment of Gastroesophageal Reflux Disease

Empiric Dilation in Non-obstructive Dysphagia

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