TY - JOUR
T1 - Manually calculated oesophageal bolus clearance time increases in parallel with reflux severity at impedance-pH monitoring
AU - de Bortoli, Nicola
AU - Martinucci, Irene
AU - Savarino, Edoardo V.
AU - Frazzoni, Marzio
AU - Tutuian, Radu
AU - Tolone, Salvatore
AU - Piaggi, Paolo
AU - Furnari, Manuele
AU - Russo, Salvatore
AU - Bertani, Lorenzo
AU - Macchia, Lorenzo
AU - Savarino, Vincenzo
AU - Marchi, Santino
PY - 2015/12/1
Y1 - 2015/12/1
N2 - Background: Oesophageal clearance has been scarcely studied. Aims: Oesophageal clearance in endoscopy-negative heartburn was assessed to detect differences in bolus clearance time among patients sub-grouped according to impedance-pH findings. Methods: In 118 consecutive endoscopy-negative heartburn patients impedance-pH monitoring was performed off-therapy. Acid exposure time, number of refluxes, baseline impedance, post-reflux swallow-induced peristaltic wave index and both automated and manual bolus clearance time were calculated. Patients were sub-grouped into pH/impedance positive (abnormal acid exposure and/or number of refluxes) and pH/impedance negative (normal acid exposure and number of refluxes), the former further subdivided on the basis of abnormal/normal acid exposure time (pH+/-) and abnormal/normal number of refluxes (impedance+/-). Results: Poor correlation (r = 0.35) between automated and manual bolus clearance time was found. Manual bolus clearance time progressively decreased from pH+/impedance+ (42.6 s), pH+/impedance- (27.1 s), pH-/impedance+ (17.8 s) to pH-/impedance- (10.8 s). There was an inverse correlation between manual bolus clearance time and both baseline impedance and post-reflux swallow-induced peristaltic wave index, and a direct correlation between manual bolus clearance and acid exposure time. A manual bolus clearance time value of 14.8 s had an accuracy of 93% to differentiate pH/impedance positive from pH/impedance negative patients. Conclusions: When manually measured, bolus clearance time reflects reflux severity, confirming the pathophysiological relevance of oesophageal clearance in reflux disease.
AB - Background: Oesophageal clearance has been scarcely studied. Aims: Oesophageal clearance in endoscopy-negative heartburn was assessed to detect differences in bolus clearance time among patients sub-grouped according to impedance-pH findings. Methods: In 118 consecutive endoscopy-negative heartburn patients impedance-pH monitoring was performed off-therapy. Acid exposure time, number of refluxes, baseline impedance, post-reflux swallow-induced peristaltic wave index and both automated and manual bolus clearance time were calculated. Patients were sub-grouped into pH/impedance positive (abnormal acid exposure and/or number of refluxes) and pH/impedance negative (normal acid exposure and number of refluxes), the former further subdivided on the basis of abnormal/normal acid exposure time (pH+/-) and abnormal/normal number of refluxes (impedance+/-). Results: Poor correlation (r = 0.35) between automated and manual bolus clearance time was found. Manual bolus clearance time progressively decreased from pH+/impedance+ (42.6 s), pH+/impedance- (27.1 s), pH-/impedance+ (17.8 s) to pH-/impedance- (10.8 s). There was an inverse correlation between manual bolus clearance time and both baseline impedance and post-reflux swallow-induced peristaltic wave index, and a direct correlation between manual bolus clearance and acid exposure time. A manual bolus clearance time value of 14.8 s had an accuracy of 93% to differentiate pH/impedance positive from pH/impedance negative patients. Conclusions: When manually measured, bolus clearance time reflects reflux severity, confirming the pathophysiological relevance of oesophageal clearance in reflux disease.
KW - Bolus clearance time
KW - GERD
KW - PH-impedance monitoring
KW - PSPW index
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U2 - 10.1016/j.dld.2015.08.010
DO - 10.1016/j.dld.2015.08.010
M3 - Article
C2 - 26362613
AN - SCOPUS:84983127185
VL - 47
SP - 1027
EP - 1032
JO - Digestive and Liver Disease
JF - Digestive and Liver Disease
SN - 1590-8658
IS - 12
ER -