Background The addition of impedance to 24-h pH monitoring has allowed detection of weakly acidic reflux, but the extent to which pH-impedance (pH-MII) monitoring improves outcomes is unknown. Methods This was a prospective observational study. Patients referred for pH or pH-MII monitoring completed a standardized questionnaire on improvement in the dominant symptom, their satisfaction, and treatment at 3 and 12 months after the test during a telephone interview. Results A total of 184 patients (mean age, 52 years, range, 19–82 years; 35 % with typical symptoms; and 89 % tested off therapy) completed pH (n = 92) or pH-MII monitoring (n = 92) over a period of 15 months. The two arms were similar in terms of demographic, clinical, and endoscopic variables. Ten patients in the pH-MII arm showed evidence of weakly acidic reflux disease. There was no difference in the percentage of patients in the pH and pH-MII monitoring arms who experienced improvement in their dominant symptom after 3 (58 vs. 63 %; p = 0.621) or 12 months (66 vs. 70 %; p = 0.234), and the same was true for patient satisfaction. There were also no between-group difference in the use of proton pump inhibitors (PPIs) after 3 (63 vs. 68.5 %; p = 0.437) or 12 months (47 vs. 60.5 %; p = 0.051). PPIs were prescribed more frequently after a positive test (p\0.001) although they were used by 45.6 % of the negative patients. Only one patient underwent fundoplication. Conclusions Two-thirds of patients undergoing pH-MII monitoring experience a positive outcome, similarly to what occurs after traditional pH monitoring. Physicians often pay little attention to the test results, especially if they are negative.
pH Impedance vs. traditional pH monitoring in clinical practice : an outcome study / D. Pugliese, A. Mauro, D. Consonni, I. Bravi, A. Tenca, A. Elvevi, D. Conte, R. Penagini. - In: JOURNAL OF GASTROENTEROLOGY. - ISSN 0944-1174. - 51:2(2016 Feb 01), pp. 130-137.
|Titolo:||pH Impedance vs. traditional pH monitoring in clinical practice : an outcome study|
PUGLIESE, DELIA (Primo)
MAURO, AURELIO (Secondo)
CONTE, DARIO (Penultimo)
PENAGINI, ROBERTO (Corresponding)
|Parole Chiave:||Gastroesophageal reflux, Impedance-pH monitoring, Patient’s outcome|
|Settore Scientifico Disciplinare:||Settore MED/12 - Gastroenterologia|
|Data di pubblicazione:||1-feb-2016|
|Data ahead of print / Data di stampa:||2-giu-2015|
|Digital Object Identifier (DOI):||http://dx.doi.org/10.1007/s00535-015-1090-z|
|Appare nelle tipologie:||01 - Articolo su periodico|