New Procedure Aids in Reflux Diagnosis

Testing patients with reflux symptoms and a negative work-up may lead to diagnosis

THURSDAY, Aug. 21 (HealthDay News) -- Multichannel intraluminal impedance pH testing may identify an etiology in patients with continued reflux symptoms, a negative endoscopy and a negative, standard 24-hour pH test, according to an article published in the August issue of Clinical Gastroenterology and Hepatology.

Michael M. Kline, M.D., of the University of Southern California Keck School of Medicine in Los Angeles, and colleagues performed multichannel intraluminal impedance 24-hour pH testing in 37 patients with heartburn or regurgitation, negative endoscopy and a negative, standard 24-hour pH test. The researchers examined whether the Symptom Index (SI) obtained using multichannel intraluminal impedance pH testing identified an association of symptoms with actual reflux events in non-classic acid-reflux disease. Based on the testing results, patients were classified into four groups: standard acid reflux (positive standard pH test); acid sensitive (positive SI for major acid but normal pH test); general reflux (positive SI for major, minor and non-acid combined, but not for major acid alone); and no reflux (negative SI).

Overall, the investigators found that 16 percent, 27 percent, 38 percent and 19 percent of patients had standard reflux, acid-sensitive esophagus, general reflux and no reflux, respectively.

"Fifty-seven percent of patients received a diagnosis unachievable with standard pH testing (38 percent had symptoms associated with general reflux and 19 percent had no reflux symptom associations)," the authors conclude. "These findings support a potential role for multichannel intraluminal impedance pH testing in this difficult group. "

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