Wireless Capsules for Esophageal pH Monitoring: Are We Placing Them Correctly?

Doma, Siva; Paladugu, Susmita; Parkman, Henry P.; Friedenberg, Frank K.

doi:10.1159/000264648

Cited by 3 publications

(2 citation statements)

References 29 publications

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“…Although additional studies are needed to validate this technique, one might assume GEJ pH mapping as a tool for pH sensor positioning before esophageal pH monitoring when LES manometry is not available or tolerated. In addition, given the increasing utilization of wireless esophageal pH monitoring in the clinical practice, 41–43 further studies are needed to assess whether GEJ pH mapping may be combined with wireless system.…”

Section: Discussionmentioning

confidence: 99%

Determination of pH turning point with pH mapping of the gastroesophageal junction: an alternative technique to orientate esophageal pH monitoring

Liell

Tomiozzo

Denti

et al. 2010

Diseases of the Esophagus

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Manometric location of the lower esophageal sphincter (LES) has been mandatory before esophageal pH monitoring, despite costs and discomfort related with esophageal manometry. The aims of the study were: (i) to map the pH of the gastroesophageal junction (GEJ) to determine a pH turning point (PTP) and its relation with LES; and (ii) to test the feasibility of this technique to orientate esophageal pH monitoring. We studied 310 adult patients who underwent esophageal manometry and pH monitoring off acid-suppressive therapy. GEJ pH mapping was carried out by step-pulling the pH sensor from 5 cm below to 5 cm above LES, and a PTP was determined when pH changed from below to above 4, in centimeters from the nostril. Thirty-six patients referred only for pH monitoring were studied with pH sensor placed at 5 cm above the PTP. Out of 310 patients, a PTP was found in 293 (94.5%): inside LES in 86.3%, into the stomach in 8.2% and in the esophageal body in 5.5% of patients. The median distance between PTP and place where pH sensor monitored reflux was 8 cm. Among 36 patients who performed pH monitoring without LES manometry, there was no gastric monitoring during reflux testing. In adult patients investigated off acid suppressive therapy, GEJ pH mapping with reflux monitoring 5 cm above the PTP can be an alternative technique to perform esophageal pH monitoring when LES manometry is not available. Additional studies are needed before the widespread use of GEJ pH mapping in the clinical practice.

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Section: Discussionmentioning

confidence: 99%

Determination of pH turning point with pH mapping of the gastroesophageal junction: an alternative technique to orientate esophageal pH monitoring

Liell

Tomiozzo

Denti

et al. 2010

Diseases of the Esophagus

View full text Add to dashboard Cite

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“…Based on these data, a placement closer to the EGJ should not be recommended to improve the diagnostic yield in patients with NERD. Finally, a retrospective study suggested that endoscopic misplacement of wireless capsules was common [14]. The authors de- Fig.…”

Section: Capsule Locationmentioning

confidence: 99%

Wireless pH capsule – yield in clinical practice

et al. 2012

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Wireless pH monitoring is one of the recent technologies that focus on improving the diagnosis of gastroesophageal reflux disease (GERD). The capsule, which is fixed within the esophagus, transmits data via telemetry to an external receiver. The capsule is usually inserted 6 cm above the squamocolumnar junction during an upper endoscopy. The standard recording duration is 48 hours but this can be extended to 96 hours. The wireless capsule has been shown to be at least as accurate as the conventional catheter for the monitoring of esophageal pH. Normal pH values have been established in three different series. The use of a wireless capsule provides an increased diagnostic yield for GERD compared with the conventional catheter. The increased yield is the result of higher sensitivity to detect both abnormal acid esophageal exposure and positive symptom-reflux association. This may be related both to the prolonged recording duration and to fewer dietary modifications and restrictions on activities. Several studies have shown that the pH capsule was better tolerated by patients than the conventional pH catheter. Mild-to-moderate chest pain represents the main side effect of the pH capsule: severe chest pain requiring endoscopic removal of the capsule is rare. The main indication for wireless capsule application is monitoring of distal esophageal pH for diagnostic purpose, particularly in patients with a normal endoscopic examination. The capsule technique has some limitations: costs are higher than conventional pH monitoring, misplacement may occur, and the sampling rate is lower. Finally, compared with pH-impedance monitoring, only acid reflux events can be evaluated.

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Wireless pH Testing

Chen,

Perry

2023

The SAGES Manual of Physiologic Evaluation of Foregut Diseases

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Wireless Capsules for Esophageal pH Monitoring: Are We Placing Them Correctly?

Cited by 3 publications

References 29 publications

Determination of pH turning point with pH mapping of the gastroesophageal junction: an alternative technique to orientate esophageal pH monitoring

Determination of pH turning point with pH mapping of the gastroesophageal junction: an alternative technique to orientate esophageal pH monitoring

Wireless pH capsule – yield in clinical practice

Wireless pH Testing

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