Twelve hour overnight oesophageal pH monitoring in patients with reflux symptoms
Article Abstract:
The contents of the stomach are extremely acidic, and can damage the esophagus if allowed to come in contact with it. Ordinarily, this is prevented by the lower esophageal sphincter, which blocks the backflow of fluids from the stomach to the esophagus. But in some individuals, the gastroesophageal sphincter does not function properly, and the resulting condition (gastroesophageal reflux) initially causes heartburn, with potential for more serious consequences such as ulceration. In many patients, surgical repair of the lower esophageal sphincter can reverse the reflux and its consequences. Protracted (either 12- or 24-hour) monitoring of esophageal pH (acidity) has been proposed as the preferred way of measuring the amount of gastroesophageal reflux. To determine whether 12-hour (overnight) esophageal pH monitoring would permit identification of patients in whom surgical repair would not alleviate the symptoms, a study was carried out with 112 patients suffering from heartburn, acid regurgitation, or both, all of whom were slated for surgical repair of the lower esophageal sphincter, and 56 patients without these symptoms (controls). Patients were first treated with medication and dietary therapy; the 51 patients who responded satisfactorily to this regimen did not undergo surgery. For those who had surgery, 12-hour esophageal pH was measured shortly before surgery (after drug and diet therapy had been attempted) and three months after surgery. Patients who underwent surgery had significantly higher esophageal acidity than either normal controls or patients who responded to drug therapy, but the latter group overlapped greatly with the surgical group. Surgical repair of the gastroesophageal sphincter decreased acid levels to those of normal controls. In those patients for whom surgery was deemed unsuccessful (on the basis of clinical observation), pre- and postoperative acid levels were similar. There was no difference in the preoperative acid level between patients for whom surgery was successful and those for whom it was not. Hence, 12-hour esophageal pH monitoring is useful in evaluating the outcome of surgical repair, but not for the prediction of which patients will respond well to the procedure. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: Gut
Subject: Health
ISSN: 0017-5749
Year: 1991
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The ion sensitive field effect transistor (ISFET) pH electrode: a new sensor for long term ambulatory pH monitoring
Article Abstract:
In the study of normal and abnormal physiology of the gastrointestinal (GI) system, it is frequently desirable to monitor the pH (acidity) of the esophagus, stomach, and intestines. In the diagnosis and treatment of ulcerative and hyperacidic states, gastric pH must frequently be monitored for extended periods of time (greater than 24 hours). With the exception of hospitalized patients, this means that other persons must be outfitted for ambulatory pH monitoring. The standard type of electrode for measuring intraluminal (esophageal, gastric, or intestinal) pH is constructed of glass. These devices suffer from a variety of drawbacks, including unsuitability for use over extended periods, inability to monitor multiple sites within the GI tract, and high cost (necessitating re-use, which may lead to possible disease transmission). The authors describe a modified field effect transistor electrode that overcomes these drawbacks, making possible disposable electrodes capable of yielding recordings from multiple sites within the GI tract over extended periods of time without the risk of infection. Comparisons between the new electrode configuration, known as the ion sensitive field effect transistor, and the standard (glass) configuration yielded very similar data; an early morning decrease in acidity was observed, as well as three meal-associated troughs in acid levels lasting from two to three hours each. If these electrodes are mass produced commercially, the resulting decrease in cost will bring them into the price range of disposable items. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: Gut
Subject: Health
ISSN: 0017-5749
Year: 1991
User Contributions:
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