The Clinical Value Of Dual-channel Mbulatory Esophageal PH Monitoring In The Diagnosis Of Esophageal Acid Reflux Disease And Risk Factors

Backgrounds and Objective Heartburn, acid regurgitation and unexplained symptoms as chronic pharyngitis, pharyngeal paresthesia, chronic cough, and hoarseness are common conditions encountered in clinical practice. Acid reflux is responsible for the majority of those symptoms:by gastro-oesophageal acid reflux to the upper esophagus or ectopic secretion of acid on proximal. There are few data on the acid exposure in the proximal esophagus and the value of using dual-channel ambulatory esophageal pH monitoring on proximal esophageal acid reflux. This study analysis the performance of dual-channel 24hr esophageal pH monitoring in 37 patients retrospectively, in order to investigate the changes of acid reflux in proximal esophageal, compare the differences between sex, age, body mass index, distal esophageal acid reflux, reflux diagnostic questionnaire(RDQ) score and the correlation between symptoms, analysis the relationship between them. To evaluate the value of dual-channel ambulatory esophageal pH monitoring in the diagnosis of proximal esophageal acid reflux disease.Materials and Methods Dual-channel ambulatory esophageal pH monitoring and GERD reflux diagnostic questionnaire score (RDQ were performed on 37 patients with typical reflux symptoms such as acid regurgitation, heartburn and (or) other unexplained extraesophageal symptoms such as chronic laryngitis, pharyngeal paresthesia, chronic cough, hoarseness. Retrospective analysis of all the results by gender, age, body mass index, distal esophageal acid exposure, RDQ scores and symptom type.Results The esophageal endoscopic findings:the proximal heterotopic gastric mucosa was found in 2 cases, and the other was normal. Dual-channel esophageal pH monitoring results shows:7 patients (20%) had abnormal proximal esophageal acid exposure only,3 (8.6%) had abnormal distal esophageal acid exposure only,7 (20%) had both proximal and distal abnormalities,18 (51.4%) had no acid exposure in both proximal and distal esophagus. Initial analysis detected a positive relationship between the distal esophagus acid exposure and the proximal. (P<0.05). A negative relationship between the proximal esophagus acid exposure and gender, BMI. Different age groups show different numbers of episodes pH<4 proximal esophageal (p<0.05). NERD+and NERD-were significantly different on number. of episodes> 5 minutes and duration of the longest episode (p<0.05). RDQ+and RDQ resulted different numbers of episodes pH<4 in the proximal (p<0.05). Comparing with EE+, EE-had a slightly low level in the numbers of episodes pH<4, total percent time pH_<4, number. of episodes > 5 minutes, duration of the longest episode and esophageal clearance (p> 0.05).Conclusions no significant differences were found between different genders, BMI group on the proximal esophageal acid exposure. The numbers of episodes pH<4 proximal esophageal between different age groups were significantly different. pH monitoring results detected a positive relationship between the abnormal distal esophagus acid exposure and the proximal. Dual-channel ambulatory esophageal pH monitoring has important clinical value in the diagnosis of heterotopic gastric mucosa in the proximal esophageal. RDQ is a useful tool in the assessment of proximal esophageal acid reflux. Dual-channel ambulatory esophageal pH monitoring shows that proximal esophageal acid exposure and GERD extraesophageal symptoms have related correlation.