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Exertional esophageal ph-metry and manometry in recurrent chest pain

World Journal of Gastroenterology 2010年第34期16卷 4305-4312页

作者： Jacek Budzyński Department of Gastroenterology Vascular Diseases and Internal Medicine Nicolaus Copernicus University in Toruń Ludwik Rydygier Collegium Medicum in Bydgoszcz Poland Ujejskiego 75 Street 85-168 Bydgoszcz Poland Division of Vascular Diseases and Internal Medicine Dr Jan Biziel University Hospital No. 2 in Bydgoszcz Ujejskiego 75 Street 85-168 Bydgoszcz Poland

AIM: To investigate the diagnostic efficacy of 24-h and exertional esophageal ph-metry and manometry in patients with recurrent chest pain. METHODS: The study included 111 patients (54% male) with recurrent angina-like chest pain, non-respon- sive to therapy with proton pump inhibitors. Sixty-five (59%) had non-obstructive lesions in coronary artery angiography, and in 46 (41%) significant coronary artery narrowing was found. In all patients, 24-h esophageal ph-metry and manometry, and treadmill stress tests with simultaneous esophageal ph-metry and manometry monitoring were performed. During a 24-h examination the percentage of spontaneous chest pain (sCP) episodes associated with acid reflux or dysmotility (symptom index, SI) was calculated. Patients with SI > 50% for acid gastroesophageal reflux (GER) were classified as having GER-related sCP. The remaining symptomatic individuals were determined as having non-GER-related sCP. During the stress test, the occurrence of chest pain, episodes of esophageal acidification (ph esophageal spasm with more than 55% of simultaneous contractions (exercise-provoked esophageal spasm or EPES) were noted. RESULTS: Sixty-eight (61%) individuals reported sCP during 24-h esophageal function monitoring. Eleven of these (16%) were classified as having GER-related sCP and 53/68 (84%) as having non-GER-related sCP. The exercise-provoked chest pain during a stress test occurred in 13/111 (12%) subjects. In order to compare the clinical usefulness of 24-h esophageal function monitoring and its examination limited only to the treadmill stress test, the standard parameters of diagnostic test evaluation were determined. The occurrence of GER- related or non-GER-related sCP was assumed as a "gold standard". Afterwards, accuracy, sensitivity and specificity were calculated. These parameters expressed a prediction of GER-related or non-GER-related sCP occurrence by the presence of chest pain, esophageal acidification and EPES

关键词： Chest pain Diagnosis esophageal manometry esophageal ph-metry Treadmill test

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Gastrointestinal function testing model using a new laryngopharyngeal ph probe(Restech)in patients after Ivor-Lewis esophagectomy

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World Journal of Gastrointestinal Oncology 2021年第6期13卷 612-624页

作者： Benjamin Babic Dolores T Müller Florian Gebauer Lars Mortimer Schiffmann Rabi R Datta WolfgangSchröder Christiane J Bruns Jessica M Leers Hans F Fuchs Department of General VisceralCancer and Transplant SurgeryUniversity of CologneCologne 50931Germany

BACKGROUND There is no established correlation between 24-h esophageal ph-metry(Eso-ph)and the new laryngopharyngeal ph-monitoring system(Restech)as only small case series ***-ph was not designed to detect laryngopharyngeal reflux(LPR)and Restech may detect LPR *** have previously published a dataset using the two techniques in a large patient collective with gastroesophageal reflux ***,patients after esophagectomy were reported to represent an ideal human reflux model as no reflux barrier *** To use a human reflux model to examine our previously published correlation in these *** Patients after Ivor Lewis esophagectomy underwent our routine follow-up program with surveillance endoscopies,computed tomography scans and further exams following *** patients with a complete check-up program and reflux symptoms were offered inclusion into this prospective study and evaluated using Restech and simultaneous ***,the relationship between the two techniques was evaluated RESULTS A total of 43 patients from May 2016-November 2018 were *** patients presented with mainly typical reflux symptoms such as heartburn(74%),regurgitation(84%),chest pain(58%),and dysphagia(47%).Extraesophageal symptoms such as cough,hoarseness,asthma symptoms,and globus sensation were also *** 24-hour ph-metry was abnormal in 88%of patients with a mean DeMeester Score of 229.45[range 26.4-319.5].Restech evaluation was abnormal in 61%of cases in this highly selective patient *** patients with abnormal supine LPR were also abnormal for supine esophageal reflux measured by conventional *** Patients following esophagectomy and reconstruction with gastric interposition can ideally serve as a human reflux ***,laryngopharyngeal reflux phases occur mainly in the upright *** this human volume-reflux model,results of simultaneous esophageal and laryngopharyngeal(Restech)ph

关键词： Gastroesophageal reflux disease Laryngopharyngeal reflux Minimally invasive esophagectomy Surgical technology Restech esophageal ph-metry

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