Skip to main content
PMC home page
Gut logoLink to Gut
. 1987 Sep;28(9):1145–1150. doi: 10.1136/gut.28.9.1145

Ambulatory 24 hour intraesophageal pH-monitoring in the diagnosis of gastroesophageal reflux disease.

F Johnsson 1, B Joelsson 1, P E Isberg 1
PMCID: PMC1433234  PMID: 3315881

Abstract

The results of ambulatory 24 hour oesophageal pH monitoring in 20 patients with established gastro-oesophageal reflux disease were compared with those of 20 healthy individuals with normal endoscopy. Cut off limits of pH 3, 4, and 5 were superior to pH 2 with respect to the discrimination of patients from normal subjects, and for the detection of pathological reflux. Using pH 4 as a cut off limit, the ambulant and recumbent periods of pH monitoring were more discriminatory than the postprandial period. Furthermore, it was possible to get complete separation between patients and normal subjects using several combinations of two reflux variables. Another group of 30 patients and 30 controls were investigated. Using percentage time at pH less than 4 as a single determinant of gastro-oesophageal reflux, the sensitivity and specificity were 87% and 97%, respectively, with 3.4% as upper limit for normality. Twenty four hour oesophageal pH monitoring in an ambulatory outpatient environment afforded clinically useful diagnostic accuracy in separating patients with gastro-oesophageal reflux disease from asymptomatic controls.

Full text

PDF
1149

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Ask P., Edwall G., Johansson K. E., Tibbling L. On the use of monocrystalline antimony pH electrodes in gastro-oesophageal functional disorders. Med Biol Eng Comput. 1982 May;20(3):383–389. doi: 10.1007/BF02442809. [DOI] [PubMed] [Google Scholar]
  2. Atkinson M., Van Gelder A. Esophageal intraluminal pH recording in the assessment of gastroesophageal reflux and its consequences. Am J Dig Dis. 1977 Apr;22(4):365–370. doi: 10.1007/BF01072195. [DOI] [PubMed] [Google Scholar]
  3. Branicki F. J., Evans D. F., Jones J. A., Ogilvie A. L., Atkinson M., Hardcastle J. D. A frequency-duration index (FDI) for the evaluation of ambulatory recordings of gastro-oesophageal reflux. Br J Surg. 1984 Jun;71(6):425–430. doi: 10.1002/bjs.1800710607. [DOI] [PubMed] [Google Scholar]
  4. Branicki F. J., Evans D. F., Ogilvie A. L., Atkinson M., Hardcastle J. D. Ambulatory monitoring of oesophageal pH in reflux oesophagitis using a portable radiotelemetry system. Gut. 1982 Nov;23(11):992–998. doi: 10.1136/gut.23.11.992. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. DeMeester T. R., Johnson L. F. The evaluation of objective measurements of gastroesophageal reflux and their contribution to patient management. Surg Clin North Am. 1976 Feb;56(1):39–53. doi: 10.1016/s0039-6109(16)40834-0. [DOI] [PubMed] [Google Scholar]
  6. DeMeester T. R., Lafontaine E., Joelsson B. E., Skinner D. B., Ryan J. W., O'Sullivan G. C., Brunsden B. S., Johnson L. F. Relationship of a hiatal hernia to the function of the body of the esophagus and the gastroesophageal junction. J Thorac Cardiovasc Surg. 1981 Oct;82(4):547–558. [PubMed] [Google Scholar]
  7. DeMeester T. R., Wang C. I., Wernly J. A., Pellegrini C. A., Little A. G., Klementschitsch P., Bermudez G., Johnson L. F., Skinner D. B. Technique, indications, and clinical use of 24 hour esophageal pH monitoring. J Thorac Cardiovasc Surg. 1980 May;79(5):656–670. [PubMed] [Google Scholar]
  8. Demeester T. R., Johnson L. F., Joseph G. J., Toscano M. S., Hall A. W., Skinner D. B. Patterns of gastroesophageal reflux in health and disease. Ann Surg. 1976 Oct;184(4):459–470. doi: 10.1097/00000658-197610000-00009. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Fink S. M., McCallum R. W. The role of prolonged esophageal pH monitoring in the diagnosis of gastroesophageal reflux. JAMA. 1984 Sep 7;252(9):1160–1164. [PubMed] [Google Scholar]
  10. Goldberg H. I., Dodds W. J., Gee S., Montgomery C., Zboralske F. F. Role of acid and pepsin in acute experimental esophagitis. Gastroenterology. 1969 Feb;56(2):223–230. [PubMed] [Google Scholar]
  11. Joelsson B. E., DeMeester T. R., Skinner D. B., LaFontaine E., Waters P. F., O'Sullivan G. C. The role of the esophageal body in the antireflux mechanism. Surgery. 1982 Aug;92(2):417–424. [PubMed] [Google Scholar]
  12. Johnson L. F., Demeester T. R. Twenty-four-hour pH monitoring of the distal esophagus. A quantitative measure of gastroesophageal reflux. Am J Gastroenterol. 1974 Oct;62(4):325–332. [PubMed] [Google Scholar]
  13. Kaye M. D. Postprandial gastro-oesophageal reflux in healthy people. Gut. 1977 Sep;18(9):709–712. doi: 10.1136/gut.18.9.709. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. Lichter I. Measurement of gastro-oesophageal acid reflux: its significance in hiatus hernia. Br J Surg. 1974 Apr;61(4):253–258. doi: 10.1002/bjs.1800610402. [DOI] [PubMed] [Google Scholar]
  15. Skinner D. B., Booth D. J. Assessment of distal esophageal function in patients with hiatal hernia and-or gastroesophageal reflux. Ann Surg. 1970 Oct;172(4):627–637. doi: 10.1097/00000658-197010000-00009. [DOI] [PMC free article] [PubMed] [Google Scholar]
  16. Spence R. A., Collins B. J., Parks T. G., Love A. H. Does age influence normal gastro-oesophageal reflux? Gut. 1985 Aug;26(8):799–801. doi: 10.1136/gut.26.8.799. [DOI] [PMC free article] [PubMed] [Google Scholar]
  17. Stanciu C., Bennett J. R. Oesophageal acid clearing: one factor in the production of reflux oesophagitis. Gut. 1974 Nov;15(11):852–857. doi: 10.1136/gut.15.11.852. [DOI] [PMC free article] [PubMed] [Google Scholar]
  18. Stanciu C., Hoare R. C., Bennett J. R. Correlation between manometric and pH tests for gastro-oesophageal reflux. Gut. 1977 Jul;18(7):536–540. doi: 10.1136/gut.18.7.536. [DOI] [PMC free article] [PubMed] [Google Scholar]
  19. TUTTLE S. G., BETTARELLO A., GROSSMAN M. I. Esophageal acid perfusion test and a gastroesophageal reflux test in patients with esophagitis. Gastroenterology. 1960 Jun;38:861–872. [PubMed] [Google Scholar]
  20. TUTTLE S. G., RUFIN F., BETTARELLO A. The physiology of heartburn. Ann Intern Med. 1961 Aug;55:292–300. doi: 10.7326/0003-4819-55-2-292. [DOI] [PubMed] [Google Scholar]
  21. Vitale G. C., Cheadle W. G., Sadek S., Michel M. E., Cuschieri A. Computerized 24-hour ambulatory esophageal pH monitoring and esophagogastroduodenoscopy in the reflux patient. A comparative study. Ann Surg. 1984 Dec;200(6):724–728. doi: 10.1097/00000658-198412000-00009. [DOI] [PMC free article] [PubMed] [Google Scholar]
  22. Vitale G. C., Sadek S., Tulley F. M., Rimmer A. R., Hunter B. E., Phelan J., Cuschieri A. Computerized 24-hour esophageal pH monitoring: a new ambulatory technique using radiotelemetry. J Lab Clin Med. 1985 Jun;105(6):686–693. [PubMed] [Google Scholar]

Articles from Gut are provided here courtesy of BMJ Publishing Group

RESOURCES