Manually calculated oesophageal bolus clearance time increases in parallel with reflux severity at impedance-pH monitoring.

de Bortoli, Nicola; Martinucci, Irene; Savarino, Edoardo V; Frazzoni, Marzio; Tutuian, Radu; Tolone, Salvatore; Piaggi, Paolo; Furnari, Manuele; Russo, Salvatore; Bertani, Lorenzo; Macchia, Lorenzo; Savarino, Vincenzo; Marchi, Santino (2015). Manually calculated oesophageal bolus clearance time increases in parallel with reflux severity at impedance-pH monitoring. Digestive and liver disease, 47(12), pp. 1027-1032. Elsevier 10.1016/j.dld.2015.08.010

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BACKGROUND Oesophageal clearance has been scarcely studied. AIMS Oesophageal clearance in endoscopy-negative heartburn was assessed to detect differences in bolus clearance time among patients sub-grouped according to impedance-pH findings. METHODS In 118 consecutive endoscopy-negative heartburn patients impedance-pH monitoring was performed off-therapy. Acid exposure time, number of refluxes, baseline impedance, post-reflux swallow-induced peristaltic wave index and both automated and manual bolus clearance time were calculated. Patients were sub-grouped into pH/impedance positive (abnormal acid exposure and/or number of refluxes) and pH/impedance negative (normal acid exposure and number of refluxes), the former further subdivided on the basis of abnormal/normal acid exposure time (pH+/-) and abnormal/normal number of refluxes (impedance+/-). RESULTS Poor correlation (r=0.35) between automated and manual bolus clearance time was found. Manual bolus clearance time progressively decreased from pH+/impedance+ (42.6s), pH+/impedance- (27.1s), pH-/impedance+ (17.8s) to pH-/impedance- (10.8s). There was an inverse correlation between manual bolus clearance time and both baseline impedance and post-reflux swallow-induced peristaltic wave index, and a direct correlation between manual bolus clearance and acid exposure time. A manual bolus clearance time value of 14.8s had an accuracy of 93% to differentiate pH/impedance positive from pH/impedance negative patients. CONCLUSIONS When manually measured, bolus clearance time reflects reflux severity, confirming the pathophysiological relevance of oesophageal clearance in reflux disease.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Gastro-intestinal, Liver and Lung Disorders (DMLL) > Clinic of Visceral Surgery and Medicine
04 Faculty of Medicine > Department of Gastro-intestinal, Liver and Lung Disorders (DMLL) > Clinic of Visceral Surgery and Medicine > Gastroenterology

UniBE Contributor:

Tutuian, Radu and Macchia, Lorenzo

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1590-8658

Publisher:

Elsevier

Language:

English

Submitter:

Lilian Karin Smith-Wirth

Date Deposited:

12 Apr 2016 17:06

Last Modified:

12 Apr 2016 17:06

Publisher DOI:

10.1016/j.dld.2015.08.010

PubMed ID:

26362613

Uncontrolled Keywords:

Bolus clearance time; GERD; PSPW index; pH-impedance monitoring

BORIS DOI:

10.7892/boris.80372

URI:

https://boris.unibe.ch/id/eprint/80372

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