NYMC Faculty Publications
Multichannel Intraluminal Impedance-pH Testing is Clinically Useful in the Management of Patients With Gastroesophageal Reflux Symptoms
Author Type(s)
Faculty
DOI
10.1007/s10620-014-3080-z
Journal Title
Digestive Diseases and Sciences
First Page
1817
Last Page
1822
Document Type
Article
Publication Date
8-1-2014
Department
Physiology
Keywords
Esophageal pH Monitoring, Female, Gastroesophageal Reflux, Humans, Male, Middle Aged, Proton Pump Inhibitors, Retrospective Studies
Disciplines
Medicine and Health Sciences
Abstract
BACKGROUND: Multichannel intraluminal impedance-pH testing (MII-pH) allows for the detection of acid and non-acid reflux, thus, increasing yield over pH testing. Limited data exist on how physicians use test results in practice.
AIM: The aim of our study was to evaluate the influence of MII-pH testing on patient care.
METHODS: We reviewed records of patients with symptoms of gastroesophageal reflux disease who underwent MII-pH testing. Management decisions evaluated included changes in prescribed medications and surgical consultation for anti-reflux surgery. Statistical analysis was performed using Pearson Chi square test, and multivariable logistic regression.
RESULTS: MII-pH testing resulted in a medication change in 41% of patients, surgical consultation in 19.7%, and anti-reflux surgery in 11.1%. In patients who were not on proton pump inhibitor (PPI) therapy, MII-pH results were most useful in the decision to start a PPI. On PPI therapy, results were more often used to decide whether to increase (32.3%) or switch the PPI (23.5%) in patients with continued acid reflux. Results were most useful to stop the PPI in normal studies (11.1%). More patients with non-acid reflux (14.3%) and normal results (19.7%) were started on a neuromodulator compared to other diagnoses. The MII-pH result was most useful in the decision to start baclofen or bethanecol when the patient was found to have non-acid reflux (25%). Patients with an abnormal MII-pH or abnormal MII alone were more likely to be referred to surgery (OR 19.5, p < 0.001; OR 19.77, p < 0.001).
CONCLUSIONS: MII-pH testing impacted medical or surgical management in over half the patients tested.
Recommended Citation
Jodorkovsky, D., Price, J. C., Kim, B., Dhalla, S., Stein, E. M., & Clarke, J. O. (2014). Multichannel Intraluminal Impedance-pH Testing is Clinically Useful in the Management of Patients With Gastroesophageal Reflux Symptoms. Digestive Diseases and Sciences, 59 (8), 1817-1822. https://doi.org/10.1007/s10620-014-3080-z
