Role of intra-oesophageal impedance monitoring in the evaluation of endoscopic gastroplication for gastro-oesophageal reflux disease
Date
2007
Authors
Conchillo, J.
Schwartz, M.
Selimah, M.
Samsom, M.
Arts, J.
Tack, J.
Sifrim, D.
Smout, A.
Editors
Advisors
Journal Title
Journal ISSN
Volume Title
Type:
Journal article
Citation
Alimentary Pharmacology and Therapeutics, 2007; 26(1):61-68
Statement of Responsibility
J. M. Conchillo, M. P. Schwartz, M. Selimah, M. Samsom, J. Arts, J. Tack, D. Sifrim & A. J. P. M. Smout
Conference Name
Abstract
Background: In the evaluation of several endoscopic antireflux procedures, a discrepancy in the degree of improvement between symptoms and objective reflux parameters as measured by pH-metry has been reported. Aim: To assess the additional value of impedance monitoring in the evaluation of endoscopic gastroplication for gastro-oesophageal reflux disease. Methods: Eighteen patients with gastro-oesophageal reflux disease were treated with three endoscopic gastroplications, and underwent 24 h pH-impedance monitoring before and 3 months after treatment. Results: Total reflux exposure time as assessed by pH-metry and impedance monitoring was significantly decreased after treatment (P = 0.047 and <0.001, respectively). When assessed with impedance monitoring, the mean number of reflux episodes was significantly decreased after the procedure (82 vs. 56, pre vs. post, P < 0.001). Furthermore, the mean numbers of liquid and acid reflux episodes in patients with symptomatic improvement were significantly reduced after treatment (P = 0.04 and 0.02, respectively). After treatment, mean volume clearance time (s) and mean number of proximal reflux episodes were significantly decreased (P < 0.001 and 0.002, respectively). Conclusions: Impedance monitoring can identify the specific effect of endoscopic gastroplication on the different types of reflux episodes with regard to gas–liquid composition and pH, as well as on volume clearance and the proximal extent of the refluxate.