The Value Of The Esophageal PH Capsule In Gastroesophageal Reflux Disease

PARTⅠThe Value of the Esophageal pH Capsule in Gastroesophageal RefluxDiseaseObjective:To investigate the role of the OMOM esophageal pH capsule on diagnosinggastroesophageal reflux disease（GERD）.Methods：After ambulatory esophageal pH monitoring acid reflux of twenty-eight GERDpatients were detected with the OMOM esophageal pH capsule,The esophageal pH capsuleand the pH probe was placed6cm above the gastroesophageal junction in standard fashion.The tolerability of the esophageal pH capsule were compared with that of conventionalcatherer-based pH monitoring systems；and the results of the esophageal pH capsule andconventional catheter-based pH monitoring systems were analysised.Results:Twenty-eight patients who were diagnosed as GERD and met entry criteria wereenrolled into the study. Four patients were excluded due to technical failure of esophagealpH capsule. Two patients were excluded after data analysis showed that their esophageal pHcapsule had early dislodged from their esophageal. Twenty-two patients were analysised inthe study. we found that the sensitivity of the esophageal pH capsule is93.33%, thespecificity is85.71%,and the accuracy is90.91%. The median total time pH<4（8.5%），erecttime pH<4（10.4%）, and number of refluxe episodes（42.6%）in D2were significantly moreelevated than those in D1. No statistical difference was noted between the two days forsupine time pH<4and. Longest reflux episode.Conclusion: The OMOM esophageal pH capsule is an effectively and safe method withexcellent tolerability as well as high accuracy, it might be considered as an excellent tool forgastroesophageal reflux disease diagnosis. PART ⅡThe Consistency of Esophageal Acid Exposure detected with WirelessEsophageal pH Capsule and Ambulatory24-Hour Esophageal pHMonitoringObjective:To evaluate the relationship between wireless and catheter-based esophageal pHmonitorings for gastroesophageal reflux disease.Methods:Twenty-four consecutive patients suspected GERD who met entry criteria werestudied. Both the distal pH probes were placed5cm proximal to LES.48-hour wirelessesophageal pH recording was performed. During the first24h, simultaneous ambulatory24-hesophageal pH recording by catheter was undertaken. The results were compared andconsistency esophageal acid exposured/discomforts were recorded.Results:Our study compared esophageal acid exposured of48-hour wireless esophageal pHmeasurement and ambulatory24-hour esophageal ph measerement. The esophageal acidexposure of wireless esophageal pH capsule was lower than that by ambulatory24-hesophageal pH monitoring(P＜0.05). There was a significant correlation(r=0.90, p<0.0001).Concordance of diagnostic of GERD was86.4%with all patients included. There werestactistical differences between day1,day2and48h wireless recordings(P＜0.05). Thepatients reported a higher level of discomfort of Vomiting and throat discomfort duringmeasurement with the conventional24-hour pH monitoring system(P＜0.05).Conclusions:There is a strong correlation and concordance between results detected bywireless esophageal pH capsule and conventional catheter-based pH monotoring, Thereforewireless pH capsule may be applied to clinical diagnosis of gastroesophageal refluxdisease.Increasing the duration of esophageal pH capsule measurement can reducemeasurement variability and increase the diagnostic yield of accuracy.