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Is the Impedance Baseline Helpful in the Evaluation of Globus Patients?

BACKGROUND/AIMS: Gastroesophageal reflux disease (GERD) has been suggested to be responsible for 23–68% of globus cases. The impedance baseline (IB) acquired by 24-hour multichannel intraluminal impedance monitoring has been proven to represent esophageal mucosal integrity. We aimed to investigate w...

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Autores principales: Chun, Yeon Joo, Choi, Myung-Gyu, Kim, Hyung Hun, Cho, Yu Kyung, Ku, AeKyeong
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Korean Society of Neurogastroenterology and Motility 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4496914/
https://www.ncbi.nlm.nih.gov/pubmed/26130634
http://dx.doi.org/10.5056/jnm14129
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author Chun, Yeon Joo
Choi, Myung-Gyu
Kim, Hyung Hun
Cho, Yu Kyung
Ku, AeKyeong
author_facet Chun, Yeon Joo
Choi, Myung-Gyu
Kim, Hyung Hun
Cho, Yu Kyung
Ku, AeKyeong
author_sort Chun, Yeon Joo
collection PubMed
description BACKGROUND/AIMS: Gastroesophageal reflux disease (GERD) has been suggested to be responsible for 23–68% of globus cases. The impedance baseline (IB) acquired by 24-hour multichannel intraluminal impedance monitoring has been proven to represent esophageal mucosal integrity. We aimed to investigate whether the IB is helpful for evaluating globus patients. METHODS: Twenty-four-hour multichannel intraluminal impedance pH tracings (MII-pH) were evaluated in globus patients. Differences in the IB between the acid reflux, non-acid reflux, and no reflux groups were analyzed. Receiver operating characteristic (ROC) curves were obtained to determine the optimal measurement point from the lower esophageal sphincter (LES). RESULTS: A total of 62 patients were analyzed. MII-pH showed that acid reflux, non-acid reflux, and no reflux were present in 13, 5, and 44 patients, respectively. The acid reflux group had a significantly lower IB than the other groups at a location 3 cm from the LES. ROC curve analysis revealed that placement at a position 3 cm from the LES resulted in moderate diagnostic accuracy (area under the curve = 0.88). When we set 2500 Ω as the cut-off value for acid reflux at a position 3 cm from the LES, the additional diagnostic yield for acid reflux was increased by 19.4% compared with that obtained by MII-pH. CONCLUSIONS: IB is complementary to pH findings enabling identification of a subset of patients with co-existing acid reflux. Catheter placement at a location 3 cm from the LES and a cut-off value of 2500 Ω may be reasonable criteria for estimating acid reflux.
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spelling pubmed-44969142015-07-09 Is the Impedance Baseline Helpful in the Evaluation of Globus Patients? Chun, Yeon Joo Choi, Myung-Gyu Kim, Hyung Hun Cho, Yu Kyung Ku, AeKyeong J Neurogastroenterol Motil Original Article BACKGROUND/AIMS: Gastroesophageal reflux disease (GERD) has been suggested to be responsible for 23–68% of globus cases. The impedance baseline (IB) acquired by 24-hour multichannel intraluminal impedance monitoring has been proven to represent esophageal mucosal integrity. We aimed to investigate whether the IB is helpful for evaluating globus patients. METHODS: Twenty-four-hour multichannel intraluminal impedance pH tracings (MII-pH) were evaluated in globus patients. Differences in the IB between the acid reflux, non-acid reflux, and no reflux groups were analyzed. Receiver operating characteristic (ROC) curves were obtained to determine the optimal measurement point from the lower esophageal sphincter (LES). RESULTS: A total of 62 patients were analyzed. MII-pH showed that acid reflux, non-acid reflux, and no reflux were present in 13, 5, and 44 patients, respectively. The acid reflux group had a significantly lower IB than the other groups at a location 3 cm from the LES. ROC curve analysis revealed that placement at a position 3 cm from the LES resulted in moderate diagnostic accuracy (area under the curve = 0.88). When we set 2500 Ω as the cut-off value for acid reflux at a position 3 cm from the LES, the additional diagnostic yield for acid reflux was increased by 19.4% compared with that obtained by MII-pH. CONCLUSIONS: IB is complementary to pH findings enabling identification of a subset of patients with co-existing acid reflux. Catheter placement at a location 3 cm from the LES and a cut-off value of 2500 Ω may be reasonable criteria for estimating acid reflux. Korean Society of Neurogastroenterology and Motility 2015-07 2015-07-03 /pmc/articles/PMC4496914/ /pubmed/26130634 http://dx.doi.org/10.5056/jnm14129 Text en © 2015 The Korean Society of Neurogastroenterology and Motility This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Chun, Yeon Joo
Choi, Myung-Gyu
Kim, Hyung Hun
Cho, Yu Kyung
Ku, AeKyeong
Is the Impedance Baseline Helpful in the Evaluation of Globus Patients?
title Is the Impedance Baseline Helpful in the Evaluation of Globus Patients?
title_full Is the Impedance Baseline Helpful in the Evaluation of Globus Patients?
title_fullStr Is the Impedance Baseline Helpful in the Evaluation of Globus Patients?
title_full_unstemmed Is the Impedance Baseline Helpful in the Evaluation of Globus Patients?
title_short Is the Impedance Baseline Helpful in the Evaluation of Globus Patients?
title_sort is the impedance baseline helpful in the evaluation of globus patients?
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4496914/
https://www.ncbi.nlm.nih.gov/pubmed/26130634
http://dx.doi.org/10.5056/jnm14129
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