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Standard acid reflux testing revisited.

C G Schowengerdt1

  • 1Genesis HealthCare Systems, Zanesville, Ohio, USA.

Digestive Diseases and Sciences
|April 25, 2001
PubMed
Summary
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Uncontrolled acid reflux often indicates esophageal dysmotility. Combining esophageal manometry, acid reflux testing, and endoscopy provides comprehensive diagnosis in one setting for better patient treatment.

Area of Science:

  • Gastroenterology
  • Esophageal Physiology

Background:

  • Uncontrolled esophageal acid reflux necessitates comprehensive diagnostic evaluation.
  • Current diagnostic methods are often staged, leading to delays in patient management.

Purpose of the Study:

  • To evaluate a combined diagnostic approach for uncontrolled esophageal acid reflux.
  • To assess the utility of integrating esophageal manometry, acid reflux testing, and esophagogastroduodenoscopy (EGD).

Main Methods:

  • A cohort of 210 patients with uncontrolled acid reflux underwent combined esophageal manometry with acid infusion, dynamic acid reflux testing, and EGD.
  • Data collected included manometry findings, acid reflux levels, and endoscopic results.

Main Results:

  • High prevalence of hiatus hernia (84%) and esophageal dysmotility (hypocontractility 18%, hypercontractility 14%, dysmotility 36%).

Related Experiment Videos

  • Significant findings included ineffective lower esophageal sphincter (64%), upper esophageal sphincter abnormalities (42% weak, 42% hypercontractile, 32% dysmotile).
  • Acid reflux disease was associated with hiatus hernia (14%) and reached various esophageal levels (16% distal, 13% mid, 40% proximal); esophagitis (47%), ulceration (29%), gastritis (52%), and Barrett's epithelium (5%) were also noted.

    • Conclusions:

    • A high number of patients with acid reflux disease exhibit esophageal dysmotility patterns.
    • Combined testing (manometry, dynamic acid reflux testing, EGD) offers a comprehensive and efficient diagnostic solution.
    • Further research is required to compare dynamic acid reflux testing with 24-hour pH monitoring.