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Articles in PresS, published online ahead of print April 10, 2002
Am J Physiol Gastrointest Liver Physiol, 10.1152/ajpgi.00470.2001
Submitted on November 5, 2001
Accepted on April 1, 2002
1 Gastroenterology Service, Cleveland Clinic, Cleveland, OH, USA
* To whom correspondence should be addressed. E-mail: shays{at}ccf.org.
Multichannel intraluminal impedance (MII) is a new diagnostic test for GERD. The objective of this report is to determine the accuracy of MII in detecting individual RE's identified by pH probe and manometry, as well as their clearing in patients with severe GERD compared to normal volunteers. Ten severe GERD patients and 10 normal volunteers underwent simultaneous manometry (7 sites: gastric, LES, esophagus (4), pharynx), pH, and MII (6 sites in esophagus) for 15 minutes in the left and right recumbent posture fasting. We found that patients had 30-fold more RE's than normal volunteers (41±11 vs 1.3±.4), and 95% of all RE's were detected by MII. An average 15-fold fall in impedance with liquid and 5-fold rise with gas made RE's and their composition easy to detect with MII. In the right recumbent posture, nearly all RE's detected by MII were liquid (98%, 98/100). In contrast, all 283 RE's detected by MII in the left recumbent posture were gas. Nearly all RE's detected by MII were cleared (98%,368/374). Mean acid clearing time was 3-fold longer (47 sec) than clearing time by either manometry (15 sec) or MII (13 sec), primarily due to acid rereflux, i.e. additional acid RE's during acid clearing. We conclude that MII is accurate in detecting RE's identified by manometry and/or pH probe, their composition, and their clearing.
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