La Tunisie medicale · 2008
[How can we optimize the performances of 24-hour esophageal pH-monitoring for the diagnosis of gastroesophageal reflux disease?].
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Karoui Sami, Serghini Meriem, Zouiten Lilia, Boubaker Jalel, Filali Azza
Аннотация
BACKGROUND: 24-hour pH esophageal monitoring represents the gold standard for the diagnosis of the gastro-esophageal reflux disease. However, it is associated certain limits, especially in front of particular situations.
AIM: To describe the means which can improve quality of the pHmetric procedure and its diagnostic performances, while insisting on simple and accessible means in current practice.
MATERIAL AND METHODS: Review of the literature.
RESULTS: The improvement of the pH monitoring performances must be done by the specific study of the night period, especially in patients having respiratory symptoms. Among these patients, the treatment of the nocturnal gastro-esophageal reflux is associated with a considerable improvement of the quality of life. In addition, the examination must be well explained to the patient, with an aim of activating the markers of events as often as possible, since a good symptomatic agreement can be associated with normal acid exposure; defining the sensitive oesophagus. This entity is important to diagnose because of the effectiveness of PPI treatment. Lastly, in patients with ENT manifestations of gastro-esophageal reflux, the use of a probe with double channel is strongly recommended, for diagnosis of proximal reflux, which could explain the symptoms and which could be treated by high doses of PPI.
CONCLUSION: The performances of 24-hour esophageal pH monitoring can be improved by simple means, of which the use will have to take account of the clinical context.
AIM: To describe the means which can improve quality of the pHmetric procedure and its diagnostic performances, while insisting on simple and accessible means in current practice.
MATERIAL AND METHODS: Review of the literature.
RESULTS: The improvement of the pH monitoring performances must be done by the specific study of the night period, especially in patients having respiratory symptoms. Among these patients, the treatment of the nocturnal gastro-esophageal reflux is associated with a considerable improvement of the quality of life. In addition, the examination must be well explained to the patient, with an aim of activating the markers of events as often as possible, since a good symptomatic agreement can be associated with normal acid exposure; defining the sensitive oesophagus. This entity is important to diagnose because of the effectiveness of PPI treatment. Lastly, in patients with ENT manifestations of gastro-esophageal reflux, the use of a probe with double channel is strongly recommended, for diagnosis of proximal reflux, which could explain the symptoms and which could be treated by high doses of PPI.
CONCLUSION: The performances of 24-hour esophageal pH monitoring can be improved by simple means, of which the use will have to take account of the clinical context.