Measuring Esophageal Motility with a New Intraluminal Impedance Device: First Clinical Results in Reflux Patients

Faß, J.; Silny, Jiri; Braun, J.; Heindrichs, U.; Dreuw, B.; Schumpelick, Volker; Rau, G.

doi:10.3109/00365529409092496

Cited by 113 publications

(79 citation statements)

References 22 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Changes of impedance corresponding to gastroesophageal reflux events were defined from the results of previous human studies [14,15,16,17]. A liquid reflux event was identified as a decrease of impedance by 50% or more from baseline in at least the two distal channels that was propagated retrogradely.…”

Section: Methodsmentioning

confidence: 99%

Evaluation of Proton Pump Inhibitor-Resistant Nonerosive Reflux Disease by Esophageal Manometry and 24-Hour Esophageal Impedance and pH Monitoring

Kawamura¹,

Hosaka

Sugiyama

et al. 2015

Digestion

View full text Add to dashboard Cite

Background: Patients with proton pump inhibitor (PPI)-resistant nonerosive reflux disease (NERD) include subgroups that have markedly different pathophysiology. This study aimed to clarify the pathophysiology of NERD by esophageal manometry with 24-hour esophageal impedance and pH monitoring. Methods: Eighteen consecutive outpatients referred to our expert center for functional gastrointestinal motility with suspected PPI-resistant NERD were enrolled. Manometry was performed to detect esophageal motility disorders. Subsequently, 24-hour esophageal impedance and pH monitoring was done while patients were on PPI therapy. Results: Manometry revealed 1 case of achalasia, 1 case of nutcracker esophagus and 3 cases of diffuse esophageal spasm. Three patients had ineffective esophageal motility, with impedance and pH monitoring being performed in 2 of them. Esophageal acid exposure (%time pH <4) was normal in both, but the symptom index (SI) was positive for nonacidic reflux in 1 patient. One of the 10 patients with normal esophageal motility had abnormal esophageal acid exposure. The SI was positive for weakly acidic and nonacidic reflux in 3 of the remaining 9 patients with normal esophageal acid exposure. Five of the other 6 patients seemed to have functional heartburn. Conclusion: A substantial percentage (28%) of patients with suspected PPI-resistant NERD had primary esophageal motility disorders. Both nonacidic reflux and weakly acidic reflux are important contributors to the symptoms of patients with PPI-resistant NERD. Esophageal manometry is required to exclude motility disorders, while 24-hour esophageal impedance and pH monitoring is invaluable for assessing symptom-reflux associations and the indications for fundoplication in patients with suspected PPI-resistant NERD.

show abstract

Section: Methodsmentioning

confidence: 99%

Evaluation of Proton Pump Inhibitor-Resistant Nonerosive Reflux Disease by Esophageal Manometry and 24-Hour Esophageal Impedance and pH Monitoring

Kawamura¹,

Hosaka

Sugiyama

et al. 2015

Digestion

View full text Add to dashboard Cite

show abstract

“…[17][18][19] A liquid reflux event was identified as a decrease of impedance by 50% or more from baseline in at least the 2 distal channels that was propagated retrogradely. Gas reflux was identified as an abrupt increase of impedance by 50% or more from baseline in at least two adjacent channels with simultaneous or near-simultaneous propagation in the retrograde direction.…”

Section: Discussionmentioning

confidence: 99%

Liquid-containing Refluxes and Acid Refluxes May Be Less Frequent in the Japanese Population Than in Other Populations: Normal Values of 24- hour Esophageal Impedance and pH Monitoring

Kawamura

Kohata

Kawami

et al. 2016

J Neurogastroenterol Motil

View full text Add to dashboard Cite

6Kurokawa general hospital, Miyagi, Japan Background/AimsTwenty-four-hour esophageal impedance and pH monitoring allows detection of all types of reflux episodes and is considered the best technique for identifying gastroesophageal refluxes. However, normative data for the Japanese population are lacking. This multicenter study aimed to establish the normal range of 24-hour esophageal impedance and pH data both in the distal and the proximal esophagus in Japanese subjects. MethodsForty-two healthy volunteers (25 men and 17 women) with a mean ± standard deviation age of 33.3 ± 12.4 years (range: 22-72 years) underwent a combined 24-hour esophageal impedance and pH monitoring. According to the physical and pH properties, distal or proximal esophageal reflux events were categorized. ResultsMedian 45 reflux events occurred in 24 hours, and the 95th percentile was 85 events. Unlike previous reports, liquid-containing reflux events are median 25/24 hours with the 95th percentile of 62/24 hours. Acidic reflux events were median 11/24 hours with the 95th percentile of 39/24 hours. Non-acidic gas reflux events were median 15/24 hours with the 95th percentile of 39/24 hours. Proximal reflux events accounted for 80% of the total reflux events and were mainly non-acidic gas refluxes. About 19% of liquid and mixed refluxes reached the proximal esophagus. ConclusionsUnlike previous studies, liquid-containing and acidic reflux events may be less frequent in the Japanese population. Non-acidic gas reflux events may be frequent and a cause of frequent proximal reflux events. This study provides important normative data for 24-hour impedance and pH monitoring in both the distal and the proximal esophagus in the Japanese population.

show abstract

“…5 The authors described a marked delay in oesophageal transport with increasing viscosity of the bolus. A significant delay of bolus transport in the inflamed oesophageal areas was also seen in reflux patients.…”

Section: Bolus Transitmentioning

confidence: 99%

“…2,3,[5][6][7][8][9][10][11][12] Figure 2. Bolus passage along a neighbouring pair of electrodes yields a typical impedance tracing, including five phases: baseline impedance during resting stage of the oesophagus (phase 1); impedance rise caused by arrival and passage of an air volume ahead of the bolus (phase 2); impedance drop and recovery caused by arrival and passage of the bolus (phase 3); impedance rise caused by wall contraction associated with lumen occlusion (phase 4) and recovery of impedance signal to baseline level during transition to resting stage (phase 5).…”

Section: Validation Studiesmentioning

confidence: 99%

Review article: intra‐oesophageal impedance monitoring for the assessment of bolus transit and gastro‐oesophageal reflux

Conchillo

Smout

2008

Aliment Pharmacol Ther

View full text Add to dashboard Cite

show abstract

Measuring Esophageal Motility with a New Intraluminal Impedance Device: First Clinical Results in Reflux Patients

Abstract: We conclude that impedance procedures may give additional significant information about bolus transport and esophageal wall movements.

Cited by 113 publications

References 22 publications

Evaluation of Proton Pump Inhibitor-Resistant Nonerosive Reflux Disease by Esophageal Manometry and 24-Hour Esophageal Impedance and pH Monitoring

Evaluation of Proton Pump Inhibitor-Resistant Nonerosive Reflux Disease by Esophageal Manometry and 24-Hour Esophageal Impedance and pH Monitoring

Liquid-containing Refluxes and Acid Refluxes May Be Less Frequent in the Japanese Population Than in Other Populations: Normal Values of 24- hour Esophageal Impedance and pH Monitoring

Review article: intra‐oesophageal impedance monitoring for the assessment of bolus transit and gastro‐oesophageal reflux

Contact Info

Product

Resources

About