Clinical esophageal pH recording: A technical review for practice guideline development

doi:10.1053/gast.1996.1101982

Gastroenterology

Volume 110, Issue 6, June 1996, Pages 1982-1996

https://doi.org/10.1053/gast.1996.1101982 Get rights and content

Abstract

Our present concept of peptic esophagitis dates back to 1935, when Winkelstein suggested that gastric secretions were the cause of mucosal damage observed in peptic esophagitis.¹

GASTROENTEROLOGY 1996;110-1982-1996

Section snippets

Technical aspects of ambulatory pH recordings

During the past decade, esophageal pH monitoring has evolved into a relatively standardized method with respect to instrumentation. It is not our intent to review that evolution or to describe the multitude of methodological modifications applied to the pH monitoring technique for data acquisition in an investigative setting. Rather, we will examine the methodological variables of the test as applied in clinical practice along with data showing the impact of these variables on pH recordings

Role of esophageal pH recording in clinical practice

Ambulatory esophageal pH recording can potentially aid in the diagnosis and management of esophageal syndromes involving gastroesophageal reflux, extraesophageal manifestations of GERD, or chest pain. In each of these clinical scenarios we will attempt to (1) identify the pH recording abnormality associated with the condition, (2) assess the potential for identifying patients on the basis of pH recordings, and (3) determine the effect of detecting pH recording abnormalities on clinical

Conclusions and clinical recommendations

Ambulatory esophageal pH monitoring has emerged as a widely available method for quantifying esophageal acid exposure, and this measurement has been invaluable as a research tool in the investigation of the pathogenesis and treatment of GERD. The test is performed with compact portable data loggers, miniature pH electrodes, and computerized data analysis. There is an emerging consensus that the pH electrode should be positioned 5 cm above the manometrically defined upper limit of the LES, that

Acknowledgments

The authors thank the participants in the American Gastroenterological Society/American Motility Society Workshops on Motility Testing in Clinical Practice held on December 8, 1995, for critique of the manuscript and guidelines. The Patient Care Committee acknowledges the following individuals, whose critiques of this review paper provided valuable guidance to the authors: Richard H. Hunt, Timothy H. Nostrant, and Joel E. Richter.

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Clinical esophageal pH recording: A technical review for practice guideline development

Abstract

Section snippets

Technical aspects of ambulatory pH recordings

Role of esophageal pH recording in clinical practice

Conclusions and clinical recommendations

Acknowledgments

J Thorac Cardiovasc Surg

Am J Med

Gastroenterology

Chest

Gastroenterology

Gastroenterology

Gastroenterology

Gastroenterology

Lancet

Gastroenterology

Gastroenterology

Gastroenterology

Am J Surg

Am J Med

Chest

Thorac Cardiovasc Surg

Gastroenterology

Am J Med

Gastroenterology

Gastroenterology

Gastroenterology

Peptic esophagitis. A new clinical entity

JAMA

Prolonged pH recording in the study of gastrooesophageal reflux

Br J Surg

Twenty-four hour pH monitoring of the distal esophagus. A quantitative measure of gastroesophageal reflux

Am J Gastroenterol

24-H pH monitoring for gastroesophageal reflux disease: already standard but not yet gold?

Am J Gastroenterol

Technical aspects of intraluminal pH-metry in man: current status and recommendations

Gut

Esophageal pH monitoring. Functional evaluation in esophageal disease

Front Gastrointest Res

Electrodes for 24 hour pH monitoring-a comparative study

Gut

Comparative study of glass and antimony electrodes for continuous oesophageal pH monitoring

Gut

The ion sensitive field effect transistor (ISFET) pH electrode: a new sensor for longterm ambulatory pH monitoring

Gut

Spatiotemporal characteristics of physiological gastroesophageal reflux

Am J Physiol

Significantly reduced acid detection at 10 centimeters compared to 5 centimeters above lower esophageal sphincter in patients with acid reflux

Am J Gastroenterol

Esophageal 24-hour pH monitoring: is prior manometry necessary for correct positioning of the electrode?

Am J Gastroenterol

Gastroesophageal pH step-up inaccurately locates proximal border of lower esophageal sphincter

Dig Dis Sci

The LES locator: accurate placement of an electrode for 24-hour pH measurement with a combined solid-state pressure transducer

Am J Gastroenterol

Development of the 24-hour intraesophageal pH monitoring composite scoring system

J Clin Gastroenterol

Ambulatory 24-hour esophageal pH monitoring. Reproducibility and variability of pH parameters

Dig Dis Sci

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

Gut

Daytime gastro-oesophageal reflux is important in oesophagitis

Gut

Computerized 24-hour ambulatory esophageal pH monitoring and esophagastroduodenoscopy in the reflux patient

Ann Surg

Reliability of 24-hour home esophageal pH monitoring in diagnosis of gastroesophageal reflux

Dig Dis Sci

A comparison of five maintenance therapies for reflux esophagitis

N Engl J Med

Ambulatory 24-hour pH-metry in the diagnosis of gastroesophageal reflux disease

Scand J Gastroenterol

What is the optimal time window in symptom analysis of 24-hour esophageal pressure and pH data?

Dig Dis Sci

The symptom index: a clinically important parameter of ambulatory 24-hour esophageal pH monitoring

Am J Gastroenterol

The symptom sensitivity index: a valuable additional parameter in 24-hour esophageal pH recording

Am J Gastroenterol

Reflux related symptoms in patients with normal oesophageal exposure to acid

Gut