Proximal sensor data from routine dual-sensor esophageal pH monitoring is often inaccurate

Dual-sensor esophageal pH monitoring is routinely used to diagnose GERD. However, the proximal sensor may not be in proximal esophagus in patients with shortened esophagi. Our objective was to determine how often the proximal sensor was misplaced and to determine the effect on pH monitoring. Superio...

Full description

Saved in:
Bibliographic Details
Published in:Digestive diseases and sciences 2004-10, Vol.49 (10), p.1607-1611
Main Authors: MCCOLLOUGH, Matt, JABBAR, Abdul, CACCHIONE, Robert, ALLEN, Jeff W, HARRELL, Steve, WO, John M
Format: Article
Language:English
Subjects:
Biological and medical sciences
Esophagus
Esophagus - physiopathology
Feeding. Feeding behavior
Female
Fundamental and applied biological sciences. Psychology
Gastroenterology. Liver. Pancreas. Abdomen
Gastroesophageal Reflux - physiopathology
Humans
Hydrogen-Ion Concentration
Male
Manometry
Medical sciences
Middle Aged
Monitoring, Physiologic
Other diseases. Semiology
Vertebrates: anatomy and physiology, studies on body, several organs or systems
Citations: Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Dual-sensor esophageal pH monitoring is routinely used to diagnose GERD. However, the proximal sensor may not be in proximal esophagus in patients with shortened esophagi. Our objective was to determine how often the proximal sensor was misplaced and to determine the effect on pH monitoring. Superior margins of the upper and lower esophageal sphincters (UES and LES) were determined prospectively in consecutive patients. Dual sensors were placed 20 and 5 cm above the LES with a fixed 15-cm spacing pH catheter. Patients were classified into subgroups based on the actual location of the proximal sensor. In 661 patients, the proximal pH sensor was in the hypopharynx in 9% of patients, within the UES in 36%, and in the proximal esophagus in 55%. Spearman's correlation for acid exposure was very good between the dual sensors when the proximal sensor was in the proximal esophagus (R = 0.76) but was poor when the proximal sensor was misplaced in the hypopharynx (R = 0.28). The proximal sensor was misplaced in 45% of patients undergoing dual-sensor esophageal pH monitoring. It is important to locate the UES by manometry before interpreting the proximal esophageal pH data.
ISSN:0163-2116
1573-2568
DOI:10.1023/b:ddas.0000043372.98660.82