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News

Improving pHmetry sensitivity for GERD diagnosis

The wireless system can improve the sensitivity of pHmetry for the diagnosis of GERD by prolonging recordings, although it under records acid exposure compared to conventional pH monitoring, finds the most recent issue of Gut.

News image

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Esophageal pH monitoring is a useful test for the diagnosis of gastro-esophageal reflux disease (GERD).

However, it has some limitations related to the nasopharyngeal electrode.

Recently, a telemetric catheter free system was developed.

Dr Bruley des Varannes and colleagues from France compared the conventional pH measurement system and the Bravo CFS.

The investigators reported that 40 patients with symptoms suggestive of GERD underwent 24 hour oesophageal pH monitoring.

The investigative team used the conventional pH measurement system with a nasopharyngeal electrode and the Bravo CFS simultaneously.

The sensitive tips of both electrodes were positioned at the same level under fluoroscopy.

Concordance of the diagnosis of GERD was 88% with the wireless Bravo CFS
Gut

In addition to automatic analysis, the team checked and characterised each reflux episode visually.

The investigators found a correlation between the 24 hour esophageal acid exposures recorded by the conventional pH measurement system and the Bravo CFS.

The team noted that 24 hour esophageal acid exposure was significantly lower with the Bravo CFS than with the conventional pH measurement system.

Consequently, with the Bravo CFS, the cut off level for the diagnosis of GERD, as calculated from the regression equation, was 3%.

After this adjustment, the team noted that concordance of the diagnosis of GERD was 88%.

Diagnosis of GERD was established in more patients with the Bravo CFS 48 hour results than with the 24 hour results.

Dr des Varannes' team concludes, “There were strong correlations between esophageal acid exposure recorded with the 2 devices.”

“However, the Bravo CFS significantly under recorded acid exposure compared with the conventional pH measurement system.”

“Provided some correcting factors are used, the Bravo CFS can improve the sensitivity of pHmetry for the diagnosis of GERD by allowing more prolonged recordings.”

Gut 2005: 54: 1682-6
15 November 2005

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