scholarly journals Extraesophageal Reflux: What Is the Best Parameter for pH-Monitoring Data Analysis from the Perspective of Patient Response to Proton Pump Inhibitors?

2013 ◽  
Vol 2013 ◽  
pp. 1-5 ◽  
Author(s):  
Karol Zelenik ◽  
Petr Matousek ◽  
Miroslav Tedla ◽  
Jakub Syrovatka ◽  
Pavel Kominek
Keyword(s):  
Proton Pump ◽  
Ph Monitoring ◽  
Demographic Data ◽  
Extraesophageal Reflux ◽  
Patient Response ◽  
Area Index ◽  
Best Parameter ◽  
Acid Exposure Time ◽  
Reflux Area Index ◽  
Dual Probe

Objectives. To analyze the pH-monitoring records of patients with suspected extraesophageal reflux (EER) using three different parameters (number of refluxes (NOR), acid exposure time (AET), and reflux area index (RAI)), with a view to determining which type of analysis is best at selecting the patients who will respond to a proton pump inhibitor (PPI).Methods. Demographic data were obtained and the level of the complaint was assessed using the Visual Analogue Scale. A dual probe pH-monitoring study was conducted. NOR greater than six, AET more than 0.1%, and RAI higher than 6.3 mpH were taken to be the thresholds for EER. Subsequently the response to a 12-week PPI trial was analyzed.Results. A total of 81 patients were analyzed. The percentages of patients with substantial EER based on NOR, AET, and RAI were 36%, 28% and 26%, respectively. Statistically significant, often positive PPI trials were confirmed in the group identified as having substantial EER using all three types of analysis. When using AET and RAI, the significance was more pronounced (P=0.012andP=0.013, resp.) in comparison with NOR (P=0.033).Conclusions. Patients with EER diagnosed using AET or RAI will respond to PPI significantly often.

Impact of different pH thresholds for 24-hour dual probe pH monitoring in patients with suspected laryngopharyngeal reflux

2007 ◽  
Vol 122 (5) ◽  
pp. 485-489 ◽  
Author(s):  
O Reichel ◽  
W J Issing
Keyword(s):  
Healthy Volunteers ◽  
Laryngopharyngeal Reflux ◽  
Ph Monitoring ◽  
Standard Test ◽  
Normative Values ◽  
Area Index ◽  
Gold Standard Test ◽  
Laryngeal Injury ◽  
Reflux Area Index ◽  
Dual Probe

AbstractObjectives:The gold standard test for laryngopharyngeal reflux is 24-hour pH monitoring, which determines the reflux area index with a pH threshold of less than four (i.e. the reflux area index four). However, refluxed pepsin is able to cause laryngeal injury at pH levels above five.Study design:Prospective study.Materials and methods:In order to establish normative values for a reflux area index with a pH threshold of less than five (i.e. the reflux area index five), 29 healthy volunteers underwent pH monitoring. In 45 patients with suspected laryngopharyngeal reflux, reflux area index four and reflux area index five were determined by pH study.Results:In healthy volunteers, the reflux area index five was 72.6 (95th percentile). In 29 of 44 patients, laryngopharyngeal reflux was diagnosed due to a reflux area index four of greater than 6.3. However, the reflux area index five revealed laryngopharyngeal reflux in six more patients.Conclusions:For exact analysis of pH monitoring results, two pH thresholds (less than four and less than five) must be considered. Further studies with a larger number of healthy volunteers are necessary in order to reveal normative values for the reflux area index five parameter.

Role of Reflux in Tracheoesophageal Fistula Problems after Laryngectomy

2010 ◽  
Vol 119 (11) ◽  
pp. 719-728 ◽  
Author(s):  
Kai J. Lorenz ◽  
Laura Grieser ◽  
Theresa Ehrhart ◽  
Heinz Maier
Keyword(s):  
Reflux Disease ◽  
Tracheoesophageal Fistula ◽  
Ph Monitoring ◽  
Absolute Number ◽  
Tracheal Mucosa ◽  
Area Index ◽  
Demeester Score ◽  
Voice Restoration ◽  
Fistula Problems ◽  
Dual Probe

Objectives The purpose of this 2-year prospective nonrandomized study was to investigate the relationship between pathological supraesophageal reflux and the occurrence of speech fistula complications, especially severe fistula enlargement, in patients who underwent total laryngectomy and prosthetic voice restoration. Methods We objectively assessed the presence of reflux disease using 24-hour dual-probe pH monitoring in 60 laryngectomized patients, correlated the incidence of tracheoesophageal fistula complications with the severity of reflux, and assessed the risk of problems by determining the absolute number of reflux events at the level of the speech fistula, the reflux area index score, and the DeMeester score. Results All patients with fistula enlargement showed highly pathological results in the diagnostic tests for reflux disease. Depending on reflux severity, the relative risk of developing fistula complications was up to 10 times higher for these patients. Conclusions We found a significant correlation between the occurrence of tracheoesophageal fistula complications and the severity of supraesophageal reflux. Potential chronic irritation of the esophageal and tracheal mucosa can possibly contribute to the development of these problems. If the presence of reflux disease has been confirmed by 24-hour dual-probe pH monitoring, patients with fistula complications should be treated with proton pump inhibitors.

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

Digestion ◽  
2015 ◽  
Vol 91 (1) ◽  
pp. 19-25 ◽  
Author(s):  
Osamu Kawamura ◽  
Hiroko Hosaka ◽  
Yasuyuki Shimoyama ◽  
Akiyo Kawada ◽  
Shiko Kuribayashi ◽  
...  
Keyword(s):  
Proton Pump Inhibitor ◽  
Proton Pump ◽  
Reflux Disease ◽  
Esophageal Manometry ◽  
Ph Monitoring ◽  
Nonerosive Reflux Disease ◽  
Esophageal Impedance

Proton pump inhibitors for reflux therapy in infants: effectiveness determined by impedance pH monitoring

2014 ◽  
Vol 30 (4) ◽  
pp. 381-385 ◽  
Author(s):  
Christoph Castellani ◽  
Andrea Huber-Zeyringer ◽  
Gerhard Bachmaier ◽  
Amulya K. Saxena ◽  
Michael E. Höllwarth
Keyword(s):  
Proton Pump Inhibitors ◽  
Proton Pump ◽  
Ph Monitoring

Post-Reflux Swallow-Induced Peristaltic Wave Index and Mean Nocturnal Baseline Impedance Predict Heartburn Response to Proton Pump Inhibitors Better than Acid Exposure Time in GERD

2017 ◽  
Vol 152 (5) ◽  
pp. S652-S653
Author(s):  
Leonardo Frazzoni ◽  
Marzio Frazzoni ◽  
Nicola de Bortoli ◽  
Salvatore Tolone ◽  
Manuele Furnari ◽  
...  
Keyword(s):  
Proton Pump Inhibitors ◽  
Exposure Time ◽  
Proton Pump ◽  
Acid Exposure ◽  
Peristaltic Wave ◽  
Acid Exposure Time ◽  
Better Than

scholarly journals Profile of patients admitted in a pulmonology ward and developing Clostridium difficile enterocolitis

Pneumologia ◽  
2019 ◽  
Vol 68 (1) ◽  
pp. 31-36
Author(s):  
Ioana Cojocaru ◽  
Livia Luculescu ◽  
Daniela Negoescu ◽  
Irina Strâmbu
Keyword(s):  
Clostridium Difficile ◽  
Proton Pump Inhibitors ◽  
Proton Pump ◽  
Respiratory Infections ◽  
Demographic Data ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Male Predominance ◽  
Number Of Patients ◽  
Lower Intestine

Abstract Clostridium difficile is an anaerobic bacterium than can colonise the lower intestine and cause enterocolitis in susceptible patients. Clostridium difficile infection (CDI) is typically a nosocomial infection, favoured by treatment with antibiotics (especially with broad-spectrum drugs), proton pump inhibitors, but also comorbidities, old age and prolonged hospitalisation. Based on the observation that in the past years, the frequency of nosocomial CDI has increased in the Institute of Pulmonology, Bucharest, this retrospective observational study aimed to analyse the characteristics of admitted patients who develop CDI, in order to identify possible particular features and risk factors. Accordingly, medical files from 80 patients admitted from January 2015 to August 2017 were analysed for demographic data, respiratory diagnosis, comorbidities, blood tests, treatments prescribed, time of CDI onset, evolution and outcome. The number of patients studied was 29 in 2015, 16 in 2016 and 35 in 2017, with slight male predominance. Totally, 54 patients (67.5%) had tuberculosis (pulmonary or pleural), 12 had lung cancer, five had respiratory infections, two had chronic obstructive pulmonary disease and seven had other diseases. All patients but nine were receiving antibiotics: tuberculosis drugs, cephalosporins, fluoroquinolones and beta-lactams. About half of the patients received proton pump inhibitors. Most patients had several comorbidities. Mean time since admittance to onset of diarrhoea was 20 days. CDI was treated with metronidazole or vancomycin. The evolution was favourable in 90% of patients, but eight patients (10%) died This study highlights a high frequency of CDI in patients treated for tuberculosis. Due to insufficient data, no epidemiological consideration could be made. Further studies are needed to assess the relationship among tuberculosis, tuberculosis treatment and CDI.

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