Journal article
Day-to-day discrepancy in Bravo pH monitoring is related to the degree of deterioration of the lower esophageal sphincter and severity of reflux disease
Surgical endoscopy, v 25(7), pp 2219-2223
01 Jul 2011
PMID: 21359906
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Background The Bravo capsule allows monitoring of esophageal acid exposure over a two-day period. Experience has shown that 24-32% of patients will have abnormal esophageal acid exposure detected on only one of the 2 days monitored. This variation has been explained by the effect of endoscopy and sedation. The aim of this study was to assess the day-to-day discrepancy following transnasal placement of the Bravo capsule without endoscopy or sedation and to determine factors related to this variability.
Methods Bravo pH monitoring was performed by transnasal placement of the capsule in 310 patients. Patients were divided into groups based on the composite pH score: both days normal, both days abnormal and only one of the 2 days abnormal. Lower esophageal sphincter (LES) characteristics were compared between groups.
Results Of the 310 patients evaluated, 60 (19%) showed a discrepancy between the 2 days. A total of 127 patients had a normal pH score on both days and 123 had an abnormal pH score on both days. Of the 60 patients with a discrepancy, 27 were abnormal the first day and 33 (55%) were abnormal the second day. Patients with abnormal esophageal acid exposure on both days had higher degrees of esophageal acid exposure and were more likely to have a defective LES compared to those with an abnormal score on only one day (35 vs. 83%, p = 0.027).
Conclusion Patients with a discrepancy between days of Bravo pH monitoring have lower esophageal acid exposure. Variability between the 2 days represents early deterioration of the gastroesophageal barrier and indicates less advanced reflux disease.
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Details
- Title
- Day-to-day discrepancy in Bravo pH monitoring is related to the degree of deterioration of the lower esophageal sphincter and severity of reflux disease
- Creators
- Shahin Ayazi - University of Southern CaliforniaJeffrey A. Hagen - University of Southern CaliforniaJoerg Zehetner - University of Southern CaliforniaFarzaneh Banki - University of Southern CaliforniaFlorian Augustin - University of Southern CaliforniaAli Ayazi - University of California SystemSteven R. DeMeester - University of Southern CaliforniaDaniel S. Oh - University of Southern CaliforniaHelen J. Sohn - University of Southern CaliforniaJohn C. Lipham - University of Southern CaliforniaTom R. DeMeester - University of Southern California
- Publication Details
- Surgical endoscopy, v 25(7), pp 2219-2223
- Publisher
- Springer Nature
- Number of pages
- 5
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Surgery
- Web of Science ID
- WOS:000291690100021
- Scopus ID
- 2-s2.0-79960397926
- Other Identifier
- 991022048376204721
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- Web of Science research areas
- Surgery