Findings of impedance pH-monitoring in patients with atypical gastroesophageal reflux symptoms

AIM This study was designed to investigate about findings of Impedance pH-monitoring in patients with atypical symptoms of GERD. BACKGROUND The routine treatment with proton pump inhibitors is not very effective in patients with atypical symptoms of Gastro-Esophageal Reflux Disease (GERD). It may be due to non-acid reflux which cannot be monitored using common methods such as pH-metry. Therefore, in these patients combinational procedure of multi channel intraluminal impedance and pH monitoring has been suggested as a new approach. PATIENTS AND METHODS Sixty patients with atypical symptoms of GERD underwent combined impedance pH-monitoring. pH of reflux episodes, type of material refluxant, blous cleaning time, proximal extension and symptoms association probability (SAP) was recorded for each patient. RESULTS Globus sensation was reported as the most common atypical symptom. 95% of patients experienced weakly acid reflux. Mixed and pure gas refluxates were more frequent than pure liquid reflux. Bolus clearing time was pathologic in 36.7% of cases and proximal extension was detected in 43 patients (71.7%). Of the 46 symptomatic patients, 33.3% had a positive SAP and 43.3% had a negative SAP. CONCLUSION The findings of current study showed that the combinational procedure of MII and pH monitoring could provide important information for resistant to treatment patients' with atypical GERD symptoms.