Teramoto MO

Language: Spanish
References: 11
Page: 127-130
PDF size: 83.29 Kb.

ABSTRACT

Gastroesophageal reflux disease (GERD) is a very common disease and its diagnosis is clinical. Although, sometimes a diagnostic test should be done e.g. patients who do not respond to therapy, with atypical symptoms or before a surgical treatment. pH-metry has been the gold standard for diagnosis of GERD, however the probe causes discomfort and sometimes patient do not tolerate it. Development of a wireless technology allow to evaluate whilst longer time (48 hours) and to avoid the unpleasantness feeling. Our objective is to report our experience with the wireless pH-metry in patients with typical or atypical symptoms of GERD and erosive esophagitis. We included 32 patients, 18 women and 14 men, with a median age of 35.5 years old. Seventeen patients with typical symptoms and 15 who were evaluated for surgical treatment. In 3 cases the capsule placement was inadequate (9.3%). Seven patients refereed mild discomfort while eating but in any case there were no need to stop or modify the procedure. In 14 cases there were differences between measures of both days, in 2 cases the result were normal with a positive symptom index. In one patient we prolonged the measure time to 84 hours. All patients refereed that they could have their routine life as usual and their compliance was acceptable. We found less events of pseudoreflux episodes or pH grifts than in the conventional pH-metry. Wireless pH-metry technology to evaluate GE RD patients is well tolerated. Its reproducibility as well as the evaluation to symptoms could be more accurate. We found that the variability of symptoms and reflux episodes between days could be important and this quality should be evaluated in further protocols.

REFERENCES

1. Ward EM, Devault KR, Bouras EP, Stark ME et al. Successful oesophageal pH monitoring with a catheter free system. Alimen Pharmacol Ther 2004; 19: 449-54.

2. Pandolfino JE, Richter JE, Ours T. Ambulatory esophageal pH monitoring using a wireless system. Am J Gastroenterol 2003; 98: 740-9.

3. Remes-Troche JM, Ibarra-Palomino J, Carmona-Sánchez R et al. Performance, tolerability and symptoms related to prolonged pH-monitoring using the Bravo system in Mexico. Am J Gastroenterol 2004; 99: s15.

4. Valdovinos MA, Remes JA, Ruiz JC, Schmulson MJ et al. Medición exitosa del pH esofágico con la cápsula Bravo en pacientes con enfermedad por reflujo gastroesofágico. Rev Gastroenterol Mex 2004; 69: 62-8.

5. Carmona-Sánchez R, Solana-Sentíes S. Eficacia, utilidad diagnóstica y tolerancia de la determinación ambulatoria del pH intraesofágico con cápsula inalámbrica. Rev Gastroenterol Mex 2004; 69: 69-75.

6. Ward EM, DeVault KR, Bouras EP, Stark ME et al. Successful esophageal pH monitoring with a catheter free system. Gastroenterology 2003; 124: A-536.

7. Portale G, Choustoulakis EM, Tamhankar AP, Almogy G et al. Evaluation of 48 hours pH monitoring with the Bravo probe, a catheter free system in 38 asymptomatic healthy volunteers. Gastroenterology 2003; 124: A-536.

8. Lacy BE, O´Shana T, Rohstein RI, Kelley ML et al. Non-endoscopic versus endoscopic placement of the bravo pH capsule. Am J Gastroent 2004; 99: s26.

9. Hila A, Agrawal A, Freeman J, Jamison S, Castell DO. Pseudorreflux: Its incidence and importance. Am J Gastroent 2004; 99: s18.

10. Cohen LB, Hightower CD, Wood DW, Wecsler JS et al. Wireless pH-metry combined with surveillance endoscopy in Barrett´s esophagus. Am J Gastroenterol 2004; 99: s13.

11. Dementriou CA, Kongara K, Grendell J, Stampe M et al. Comparison of the 48 hour bravo capsule versus the traditional(< de 3 veces por semana) 24 hour dual channel pH probe in the evaluation of extraesophageal GERD. Am J Gastroenterol 2004; 99: s5.