Non-Acid Reflux: Detection by Multichannel Intraluminal Impedance and pH, Clinical Significance and Management

2009 ◽  
Vol 104 (2) ◽  
pp. 277-280 ◽  
Author(s):  
Marcelo F Vela
Keyword(s):  
Clinical Significance ◽  
Acid Reflux ◽  
Multichannel Intraluminal Impedance ◽  
Intraluminal Impedance

Time to Stop Blaming Gastroesophageal Reflux

2011 ◽  
Vol 50 (12) ◽  
pp. 1110-1115 ◽  
Author(s):  
Jose M. Garza ◽  
Cade M. Nylund ◽  
Ajay Kaul
Keyword(s):  
Gastroesophageal Reflux ◽  
Retrospective Review ◽  
Acid Reflux ◽  
Acid Suppression ◽  
Multichannel Intraluminal Impedance ◽  
Children's Hospital ◽  
Intraluminal Impedance ◽  
Nonacid Reflux ◽  
Reflux Event ◽  
Children’S Hospital

Objectives. Cough, pain, and desaturation episodes in infants are often ascribed to gastroesophageal reflux, and many are empirically treated with acid suppression medications. The authors hypothesize that most of these symptoms are not related to gastroesophageal reflux. Methods. Retrospective review of 186 combined pH–multichannel intraluminal impedance studies performed in infants at Cincinnati Children’s Hospital. Results. Of 4159 symptoms reported 1504 (36%) were associated with reflux events (27% nonacid and 9% acid). When total number of symptoms and reflux events were taken into consideration, nonacid reflux events were as likely to be associated with a symptom as acid reflux events ( P = .66). Conclusion. The extra-esophageal symptoms commonly attributed to gastroesophageal reflux in infants are most often not associated with a reflux event. Even though causality cannot be definitively proven, in the minority in whom a symptom association is observed, nonacid events are as likely as acid events to cause symptoms.

scholarly journals The Effect of Laparoscopic Nissen Fundoplication (LNF) on Acid and Non Acid Reflux. A Prospective Evaluation at 1, 3 and 6 Months Using 24-h pH-Multichannel Intraluminal Impedance (MII-pH)

2011 ◽  
Vol 140 (5) ◽  
pp. S-1017-S-1018
Author(s):  
Antonio Ramos-De la Medina ◽  
Maura Torres-Aguilera ◽  
Maria Fernanda Gonzalez-Medina ◽  
Alberto Aviles-Calderon ◽  
Federico B. Roesch ◽  
...  
Keyword(s):  
Nissen Fundoplication ◽  
Acid Reflux ◽  
Laparoscopic Nissen Fundoplication ◽  
Prospective Evaluation ◽  
Multichannel Intraluminal Impedance ◽  
Intraluminal Impedance ◽  
Laparoscopic Nissen

scholarly journals Critical Analysis of Esophageal Multichannel Intraluminal Impedance Monitoring 20 Years Later

2012 ◽  
Vol 2012 ◽  
pp. 1-9 ◽  
Author(s):  
Fernando A. M. Herbella
Keyword(s):  
Critical Analysis ◽  
Acid Reflux ◽  
Clinical Applications ◽  
Multichannel Intraluminal Impedance ◽  
Esophageal Diseases ◽  
Esophageal Function ◽  
Bolus Transit ◽  
Intraluminal Impedance ◽  
Esophageal Physiology ◽  
Impedance Monitoring

Multichannel intraluminal impedance (MII) for the evaluation of esophageal diseases was created in 1991 trying to solve previous limitations of esophageal function test. MII-pH is able to determine the physical characteristics of the refluxate (liquid, gas, or mixed) and nonacidic GER. MII-manometry can determine the presence of bolus and its relation with peristalsis. This paper makes a critical analysis of the clinical applications of MII 20 years after its creation. Literature review shows that MII made great contributions for the understanding of esophageal physiology; however, direct clinical applications are few. MII-pH was expected to identify patients with normal acid reflux and abnormal nonacidic reflux. These patients are rarely found off therapy, that is, nonacidic reflux parallels acid reflux. Furthermore, the significance of isolated nonacidic reflux is unclear. Contradictory MII-manometry and conventional manometry findings lack better understanding and clinical implication as well as the real significance of bolus transit.

Strong Intra-Esophageal Reflux May Contribute to the Development of Barrett’s Adenocarcinoma and Affect the Localization

Digestion ◽  
2019 ◽  
Vol 101 (6) ◽  
pp. 752-760
Author(s):  
Masahiro Saito ◽  
Tomoyuki Koike ◽  
Kenichiro Nakagawa ◽  
Yasuaki Abe ◽  
Kazuaki Norita ◽  
...  
Keyword(s):  
Ph Monitoring ◽  
Acid Reflux ◽  
Esophageal Reflux ◽  
Multichannel Intraluminal Impedance ◽  
Weakly Acid ◽  
Intraluminal Impedance ◽  
Total Reflux ◽  
Barrett’S Adenocarcinoma ◽  
Acid Exposure Time ◽  
Multichannel Intraluminal Impedance Ph

<b><i>Background:</i></b> There has been no study that has directly measured the esophageal reflux factors in Barrett’s adenocarcinoma (BA) using 24-h multichannel intraluminal impedance-pH monitoring (24-h MII-pH). We aimed to clarify the esophageal reflux factors in Barrett’s esophagus (BE) and BA and the factors that determine the location of BA with 24-h MII-pH. <b><i>Methods:</i></b> We performed 24-h MII-pH in 26 patients with superficial BA treated endoscopically (BA group) and 13 patients with BE (BE group) and examined the esophageal reflux factors (esophageal acid exposure time [AET], bolus exposure (acid, weakly acid, and alkaline), and number of reflux episodes. In the BA group, there were 16 cases in which the lesions were localized in an area in contact with the esophagogastric junction (EGJ; EGJ group), and 10 cases in which the lesions were proximal to the BE and separated from the EGJ (non-EGJ group). <b><i>Results:</i></b> Total reflux in the bolus exposure in the BA group showed higher values compared to that in the BE group. The total of acid and weakly acid reflux of bolus exposure was significantly higher in the BA group than that in the BE group. The BA group also had greater numbers of total reflux episodes than the BE group. As for the cancer locations in BE, the cases in which the lesions were located proximally and separated from the EGJ had more AET and total reflux and acid reflux indicated by bolus exposure compared to the lesions adjacent to the EGJ. <b><i>Conclusions:</i></b> Stronger gastro-esophageal reflux appeared to be an important factor in the development of adenocarcinoma from BE. In addition, the cancer location in BE may be related to the intensity of esophageal reflux.

Comparison Between Manual and Automated Analyses in Multichannel Intraluminal Impedance: pH Monitoring for Laryngopharyngeal Reflux

2021 ◽  
pp. 019459982110069
Author(s):  
Hee Jin Kang ◽  
Jung Min Park ◽  
Soo Young Choi ◽  
Su Il Kim ◽  
Young Chan Lee ◽  
...  
Keyword(s):  
Laryngopharyngeal Reflux ◽  
Ph Monitoring ◽  
Automated Analysis ◽  
Acid Reflux ◽  
Multichannel Intraluminal Impedance ◽  
Symptom Index ◽  
Manual Analysis ◽  
Intraluminal Impedance ◽  
Symptom Association Probability ◽  
Multichannel Intraluminal Impedance Ph

Objective To evaluate differences between manual and automated analyses of 24-hour multichannel intraluminal impedance–pH monitoring for diagnosis of laryngopharyngeal reflux. Study Design Case series with planned data collection. Setting Academic center outpatient clinic. Methods The study group comprised 127 patients with symptoms suspicious of laryngopharyngeal reflux, who underwent 24-hour multichannel intraluminal impedance–pH monitoring. Automated and manual analyses were performed for each patient. The following parameters were compared between analyses: number of proximal reflux episodes, proximal exposure time, symptom index, and symptom association probability. Results The number of proximal reflux episodes detected by manual analysis was significantly lower than that detected by automated analysis, except in acid reflux cases. The false positive of automated analysis was 39.8%. In addition, the proximal exposure time for manual analysis was significantly lower than that for automated analysis, except in cases of acid reflux. Symptom index and symptom association probability values based on manual analysis were significantly lower than in automated analysis, except in heartburn cases. Conclusions Automated analysis demonstrated a tendency of excessive reflux measurement when compared with manual analysis. It is necessary to increase the accuracy of laryngopharyngeal reflux diagnosis through manual analysis.

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