Background and aim: Twenty-four hours pH-metry and multichannel intraluminal impedance (MII) monitoring allows the simultaneous assessment of the chemical and physical properties of the gastroesophageal reflux (GER). To investigate 24h pH-metry+MII in normal weight, overweight, obese (class I, II, III) patients with GERD symptoms. Material and methods: A total of 41 patients (19M/22F, age 22-71 yrs, BMI 18.7-55.9 kg/m2) with GERD symptoms were admitted consecutively to the study, under informed consent. Ten normal weight subjects with normal 24-h pH-metry+MII were used as control group. PPI and H2RA were discontinued at least 2 wks before the exam. The patients were divided into five subgroups, Normal weight (NW), Overweight (OW), Obesity class I, II, III. 24h pH-metry+MII monitoring was carried out by recording system (Sandhill Scientific, Inc.Co, USA). Electrodes at 3, 5, 7, 9, 15 and 17 cm above LES. Statistical analysis by PASW 18.0 (SPSS, Chicago, IL, USA). The values were recorded as median (Mdn) and [25th,75th,95th] percentile. Significance with p<0.05. Results: GERD symptoms were recorded by means of standardized questionnaire. Reflux episodes (total, total acid, total weakly acidic); position detected episodes (upright, recumbent); reflux episodes extent (total proximal, proximal acid, proximal weakly acidic, distal acid, distal weakly acidic) were recorded. Recumbent position episodes were significantly increased in GERD patients: OW (Mdn=11 [4,16,46]), class I (Mdn=48 [17,74,83]), class II (Mdn=15 [10,17,21]), class III (Mdn=11 [7,18,30]) in comparison with NW (Mdn=2 [1,2,12]) and healthy controls (Mdn=2 [1,3,7]). Proximal extent episodes were significantly increased in overweight (Mdn=31[19,34,63]), class I (Mdn=10 [4,20,35]), class II (Mdn=44 [32,59,66]),and class III (Mdn=39 [29,50,58]) patients vs healthy controls (Mdn=13,5 [11,16,22]). Proximal acid episodes were significantly higher in class II (Mdn=31 [29,38,44]) and class III (Mdn=27 [23,38,49]) vs controls (Mdn=8 [4,12,21]). Conclusions: Acid reflux episodes with proximal extent were significantly increased in patients with BMI≥35. Increased reflux episodes in the recumbent body position were observed in all groups of patients with BMI≥25.
ESOPHAGEAL 24-H-PH-METRY AND MULTICHANNEL INTRALUMINAL IMPEDANCE (MII) IN NORMALWEIGHT AND IN OBESE PATIENTSWITH GERD SYMPTOMS
RICCI, Giorgio;ALVISI, Vittorio
2011
Abstract
Background and aim: Twenty-four hours pH-metry and multichannel intraluminal impedance (MII) monitoring allows the simultaneous assessment of the chemical and physical properties of the gastroesophageal reflux (GER). To investigate 24h pH-metry+MII in normal weight, overweight, obese (class I, II, III) patients with GERD symptoms. Material and methods: A total of 41 patients (19M/22F, age 22-71 yrs, BMI 18.7-55.9 kg/m2) with GERD symptoms were admitted consecutively to the study, under informed consent. Ten normal weight subjects with normal 24-h pH-metry+MII were used as control group. PPI and H2RA were discontinued at least 2 wks before the exam. The patients were divided into five subgroups, Normal weight (NW), Overweight (OW), Obesity class I, II, III. 24h pH-metry+MII monitoring was carried out by recording system (Sandhill Scientific, Inc.Co, USA). Electrodes at 3, 5, 7, 9, 15 and 17 cm above LES. Statistical analysis by PASW 18.0 (SPSS, Chicago, IL, USA). The values were recorded as median (Mdn) and [25th,75th,95th] percentile. Significance with p<0.05. Results: GERD symptoms were recorded by means of standardized questionnaire. Reflux episodes (total, total acid, total weakly acidic); position detected episodes (upright, recumbent); reflux episodes extent (total proximal, proximal acid, proximal weakly acidic, distal acid, distal weakly acidic) were recorded. Recumbent position episodes were significantly increased in GERD patients: OW (Mdn=11 [4,16,46]), class I (Mdn=48 [17,74,83]), class II (Mdn=15 [10,17,21]), class III (Mdn=11 [7,18,30]) in comparison with NW (Mdn=2 [1,2,12]) and healthy controls (Mdn=2 [1,3,7]). Proximal extent episodes were significantly increased in overweight (Mdn=31[19,34,63]), class I (Mdn=10 [4,20,35]), class II (Mdn=44 [32,59,66]),and class III (Mdn=39 [29,50,58]) patients vs healthy controls (Mdn=13,5 [11,16,22]). Proximal acid episodes were significantly higher in class II (Mdn=31 [29,38,44]) and class III (Mdn=27 [23,38,49]) vs controls (Mdn=8 [4,12,21]). Conclusions: Acid reflux episodes with proximal extent were significantly increased in patients with BMI≥35. Increased reflux episodes in the recumbent body position were observed in all groups of patients with BMI≥25.I documenti in SFERA sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
