Research on Gastroesophageal Reflux Disease Based on Dynamic Features of Ambulatory 24-Hour Esophageal pH Monitoring

Liu, Shuang; Xu, Minpeng; Yang, Jiajia; Qi, Hongzhi; He, Feng; Zhao, Xin; Zhou, Peng; Zhang, Lixin; Ming, Dong

doi:10.1155/2017/9239074

Cited by 7 publications

(4 citation statements)

References 28 publications

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“…Based on a cut-off DeMeester Score of 14.72, 39 (71%) subjects had clinically significant reflux on the preceding 24-hour oesophageal pH monitoring. The median DeMeester Score in these patients with significant reflux was 45.3 (IQR: 21.8 to 57.4) [19].…”

Section: Subject Demographic and Clinical Investigation Resultsmentioning

confidence: 90%

Prevalence and effects of gastro-oesophageal reflux during spirometry in subjects undergoing reflux assessment

Zhou

Teo

et al. 2020

PLoS ONE

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Variability during spirometry can persist despite control of technical and personal factors. We postulate spirometry induces gastro-oesophageal reflux (GOR), which may cause variability and affect results of spirometry. Fifty-eight (58) subjects undergoing GOR investigation with oesophageal manometry and 24hr pH monitoring were recruited. Oesophageal dysmotility and GOR were assessed as part of clinical care. Subjects performed 2 sets of spirometry separated by a 10-minute rest period. The assessment of GOR during spirometry procedure (defined by a lower oesophageal pH<4) started from the first set of spirometry and concluded when the second set of spirometry was completed. We calculated variability (%) of FEV 1 , FVC and PEFR within each set as well as changes over 10-minutes. Twenty-six subjects (45%) recorded GOR during assessment. Of these, 23 subjects recorded GOR during the 10-minute rest period. Four subjects had GOR recorded only during spirometry tests. We did not find variability of spirometry parameters between the groups with and without GOR during spirometry procedure. However, in subjects with GOR, we found small but significant reductions of PEFR (0.5L/s, 8%, p<0.001) and FEV 1 (84 mL, 3%, p = 0.048) in the second set of spirometry compared to the first spirometry set. This pilot study demonstrates that GOR can occur during and following spirometry. Presence of GOR during spirometry in this patient population caused small decreases in PEFR and FEV 1 when it is repeated 10-minutes later however not increase variability in a single series of measurements.

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Section: Subject Demographic and Clinical Investigation Resultsmentioning

confidence: 90%

Prevalence and effects of gastro-oesophageal reflux during spirometry in subjects undergoing reflux assessment

Zhou

Teo

et al. 2020

PLoS ONE

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“…The data were recorded by a portable digital data logger for 24 hours, and DeMeester score was calculated using a standard software program (16). Pathologic acid reflux was diagnosed as DeMeester score ≥14.72 (32) or distal esophageal acid exposure time (AET) ≥ 6% (11,16). The examination with 24 hour pH-metry was preplanned and performed only in patients with T2DM.…”

Section: Ambulatory 24-hour Ph-metrymentioning

confidence: 99%

Erosive Esophagitis and Symptoms of Gastroesophageal Reflux Disease in Patients with Morbid Obesity with and without Type 2 Diabetes: a Cross-sectional Study

et al. 2020

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Type 2 diabetes (T2DM) is associated with gastroesophageal reflux disease (GERD) in the general population, but the relationship between these conditions in candidates for bariatric surgery is uncertain. We compared the prevalence of GERD and the association between GERD-symptoms and esophagitis among bariatric candidates with and without T2DM. Methods: Cross sectional study of baseline data from the Oseberg study in Norway. Both groups underwent gastroduodenoscopy and completed validated questionnaires: Gastrointestinal Symptom Rating Scale and Gastro Esophageal Reflux Disease Questionnaire. Participants with T2DM underwent 24-hour pH-metry. Results: A total of 124 patients with T2DM, 81 women, mean (SD) age 48.6 (9.4) years and BMI 42.3 (5.5) kg/m 2 , and 64 patients without T2DM, 46 women, age 43.0 (11.0) years and BMI 43.0 (5.0) kg/m 2 , were included. The proportions of patients reporting GERD-symptoms were low (< 29%) and did not differ significantly between groups, while the proportions of patients with esophagitis were high both in the T2DM and non-T2DM group, 58% vs 47%, p=0.16. The majority of patients with esophagitis did not have GERD-symptoms (68%-80%).Further, 55% of the patients with T2DM had pathologic acid reflux. Among these, 71% also had erosive esophagitis, whereof 67% were asymptomatic. Conclusions:The prevalence of GERD was similar in bariatric patients with or without T2DM, and the proportion of patients with asymptomatic GERD was high independent of the presence or absence of T2DM. Accordingly, GERD may be underdiagnosed in patients not undergoing a preoperative endoscopy or acid reflux assessment.

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“…The P -value among the three groups was 0.587. The severity of GERD was categorized according to the value of DeMeester scores 16 ; no differences were observed regarding the degree of severity of GERD among the three groups.…”

Section: Resultsmentioning

confidence: 99%

Impact of CYP2C19 metabolizer status on esophageal mucosal inflammation, acid exposure, and motility among patients on chronic proton-pump inhibitor therapy with refractory symptoms of gastroesophageal reflux disease

Tai,

Medwid,

Mclntosh

et al. 2024

Journal of the Canadian Association of Gastroenterology

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Background The extent of disease severity remains unclear among CYP2C19 rapid and ultra-rapid metabolizers with refractory symptoms of gastroesophageal reflux disease (GERD) on chronic proton-pump inhibitors (PPIs). Aims To determine the impact of CYP2C19 metabolizer status in relation to chronic PPI therapy with a focus on the extent of esophageal inflammation, acid exposure, and motor function. Methods This retrospective study included 54 patients with refractory GERD symptoms who underwent CYP2C19 genotyping for PPI metabolism, esophagogastroduodenoscopy, ambulatory pH study, and high-resolution esophageal manometry. Patients were divided into three groups: normal metabolizer (NM) group, intermediate metabolizer/poor metabolizer (IM/PM) group, and rapid metabolizer/ultra-rapid metabolizer (RM/UM) group. The Chi-square test was used to analyze categorical variables, and one-way ANOVA for comparing means. Results Rapid metabolizer/ultra-rapid metabolizer (RM/UM) group more frequently had either Los Angeles grade C or D GERD (7/19, 36.8% vs 1/21, 4.8%, P = 0.011) and metaplasia of the esophagus (9/19, 47.4% vs 2/21, 9.5%, P = 0.007) when compared to the NM group. RM/UM group were more frequently offered dilatation for nonobstructive dysphagia (8/19, 42.1% vs 3/21, 14.3%, P = 0.049) and more exhibited a hypotensive lower esophageal sphincter (LES) resting pressure compared to the NM group (10/19, 52.6% vs 4/21, 19%, P = 0.026). All three groups exhibited comparable DeMeester scores when PPIs were discontinued 72 hours before the ambulatory pH study. Conclusion CYP2C19 RMs and UMs on chronic PPI with refractory GERD symptoms exhibited greater esophageal mucosal inflammation, as observed both endoscopically and histologically, and more were found to have hypotensive LES resting pressures and more were offered esophageal dilatation.

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Research on Gastroesophageal Reflux Disease Based on Dynamic Features of Ambulatory 24-Hour Esophageal pH Monitoring

Cited by 7 publications

References 28 publications

Prevalence and effects of gastro-oesophageal reflux during spirometry in subjects undergoing reflux assessment

Prevalence and effects of gastro-oesophageal reflux during spirometry in subjects undergoing reflux assessment

Erosive Esophagitis and Symptoms of Gastroesophageal Reflux Disease in Patients with Morbid Obesity with and without Type 2 Diabetes: a Cross-sectional Study

Impact of CYP2C19 metabolizer status on esophageal mucosal inflammation, acid exposure, and motility among patients on chronic proton-pump inhibitor therapy with refractory symptoms of gastroesophageal reflux disease

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