Background and aim: Twenty-four hours pH-metry and multichannel intraluminal impedance (MII) monitoring allows the simultaneous assessment of the chemical and physical properties of the gastroesophageal reflux (GER). To investigate GER with 24h pH-metry+MII in asymptomatic obese patients and in GERD symptomatic nonobese patients. Material and methods: From April to July 2009 twelve obese patients (8M/4F, age 31-49 yrs, BMI 42.4±7.4 kg/m2) were admitted consecutively to the study, under informed consent. Eleven nonobese patients with GERD symptoms (6M/5F, age 31-61 yrs) were used as control group. PPI and H2RA were discontinued at least 2 wks before the exam. 24h pH-metry+MII monitoring was carried out by recording system (Sandhill Scientific, Inc.Co, USA). Impedance electrodes at 3, 5, 7, 9, 15 and 17 cm above LES. Statistical analysis by SPSS 15.0 (SPSS, Chicago, IL, USA). Results: No GER symptom was recorded in obese patients. The relevant mea- surements obtained with 24 h-pH-metry+MII are herein reported with p value in patients and controls respectively. The median values are compared between the two groups for DeMeester score (25 vs 12, p=0.009), acid clearance time percent, (5.4 vs 2.2, p=0.007), total number of proximal (at least 15 cm form LES) refluxes (39.8 vs 29.2, p=0.21), proximal migration reflux % episodes (56.2 vs 29.2, p=0.08), total upright reflux episodes (89.7 vs 62.7, p=0.15), total recumbent reflux episodes (19.4 vs 7.8, p=0.013), acid liquid-mixed reflux episodes (38 vs 0, p=0.004), nonacid liquid-mixed reflux episodes (14.5 vs 28, p=0.09), total reflux episodes (68.5 vs 50, p=0.52), median time of bolus clearance (11.5 vs 10, p=0.21). Waist circumference showed a negative correlation with the total number of proximal refluxes (r= -0.62, p=0.033). Conclusions: Despite the absence of GER symptoms, in our obese patients DeMeester score and acid clearance time were significantly higher than controls. The number of recumbent reflux episodes and acid reflux episodes was significantly higher than symptomatic controls. The comparisons with controls highlighted a relevant acid GER in obese group. Unlike previous report (Schneider et al, 2008) waist circumference showed a significant neg- ative correlation with the number of refluxes (acid/nonacid) detected in the proximal esophagus.
ESOPHAGEAL 24 H PH-METRY AND MULTICHANNEL INTRALUMINAL IMPEDANCE (MII) IN ASYMPTOMATIC OBESE PATIENTS AND IN NONOBESE PATIENTS WITH GERD
RICCI, Giorgio;ALVISI, Vittorio
2010
Abstract
Background and aim: Twenty-four hours pH-metry and multichannel intraluminal impedance (MII) monitoring allows the simultaneous assessment of the chemical and physical properties of the gastroesophageal reflux (GER). To investigate GER with 24h pH-metry+MII in asymptomatic obese patients and in GERD symptomatic nonobese patients. Material and methods: From April to July 2009 twelve obese patients (8M/4F, age 31-49 yrs, BMI 42.4±7.4 kg/m2) were admitted consecutively to the study, under informed consent. Eleven nonobese patients with GERD symptoms (6M/5F, age 31-61 yrs) were used as control group. PPI and H2RA were discontinued at least 2 wks before the exam. 24h pH-metry+MII monitoring was carried out by recording system (Sandhill Scientific, Inc.Co, USA). Impedance electrodes at 3, 5, 7, 9, 15 and 17 cm above LES. Statistical analysis by SPSS 15.0 (SPSS, Chicago, IL, USA). Results: No GER symptom was recorded in obese patients. The relevant mea- surements obtained with 24 h-pH-metry+MII are herein reported with p value in patients and controls respectively. The median values are compared between the two groups for DeMeester score (25 vs 12, p=0.009), acid clearance time percent, (5.4 vs 2.2, p=0.007), total number of proximal (at least 15 cm form LES) refluxes (39.8 vs 29.2, p=0.21), proximal migration reflux % episodes (56.2 vs 29.2, p=0.08), total upright reflux episodes (89.7 vs 62.7, p=0.15), total recumbent reflux episodes (19.4 vs 7.8, p=0.013), acid liquid-mixed reflux episodes (38 vs 0, p=0.004), nonacid liquid-mixed reflux episodes (14.5 vs 28, p=0.09), total reflux episodes (68.5 vs 50, p=0.52), median time of bolus clearance (11.5 vs 10, p=0.21). Waist circumference showed a negative correlation with the total number of proximal refluxes (r= -0.62, p=0.033). Conclusions: Despite the absence of GER symptoms, in our obese patients DeMeester score and acid clearance time were significantly higher than controls. The number of recumbent reflux episodes and acid reflux episodes was significantly higher than symptomatic controls. The comparisons with controls highlighted a relevant acid GER in obese group. Unlike previous report (Schneider et al, 2008) waist circumference showed a significant neg- ative correlation with the number of refluxes (acid/nonacid) detected in the proximal esophagus.I documenti in SFERA sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
