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pH monitoring: The gold standard in detection of gastrointestinal reflux disease?

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Abstract

Gastroesophageal reflux disease (GERD) is one of the most frequent benign diseases of the gastrointestinal tract and in some cases the diagnosis may be very difficult. There are many diagnostic procedures but none of them could prove or definitely exclude the disease. The 24-h pH-monitoring is the “gold standard” for detection of gastroesophageal reflux and in many patients the reflux correlates with the GERD. The evaluation of a diagnostic method has to be done in a similar manner to the evaluation of therapeutic study (phase 1 to phase 4). For the definition of the “gold standard” for detection of a special diagnosis (e.g., the gastroesophageal reflux disease), the results of phase 3 studies for different methods had to be compared. The method with the best values for sensitivity and specificity is yet to be discovered. Until now, pH monitoring has been the gold standard for the diagnosis of GERD. However, there are many problems connected with using this method in clinical practice.

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References

  1. 1.

    Gallup Organization 1988: Heartburn across America: a Gallup Organization national survey. Princeton, NJ

  2. 2.

    Dodds WJ, Hauser R, Hogan WJ, Dent J: Gastroesophageal reflux (GER) and esophageal clearance in normal volunteers and patients with reflux esophagitis. In: Christensen J (ed.):Gastrointestinal Motility. New York: Raven Press, 1980, pp 87–88

  3. 3.

    Weiser HF, Bollschweiler E, Lange R, Siewert JR: Update on esophageal pH-monitoring. In: De Meester TR, Matthews HR (eds.):International Trends in General Thoracic Surgery, Vol. 3.Benign Esophageal Disease. St. Louis: C.V. Mosby (1987), pp 31–39

  4. 4.

    Jenkinson LR, Norris TL, Watson A: The role of acid exposure in the inition and progression of reflux oesophagitis. In Fuchs KH, Hamelmann H (eds.):Gastrointestinale Funktionsdiagnostik in der Chirurgie. Berlin: Blackwell Wissenschaft, 1991, pp 40–54

  5. 5.

    Johnson LF, DeMeester TR: Development of the 24-hour intraesophageal pH monitoring composite scoring system.J Clin Gastroenterol 8:52–58, 1986

  6. 6.

    Hölscher AH, Bollschweiler E, Bumm R: pH-Metrie von Oesophagus und Magen. In: Classen M, Siewert JR, Blum AL (ed.).Aktuelle gastroenterologische Diagnostik 2. Auflage, Berlin: Springer-Verlag, 1992

  7. 7.

    Fletcher RH, Fletcher SW, Wagner EH:Clinical Epidemiology—the Essentials. Baltimore: Williams & Wilkins, 1988, pp 43–44

  8. 8.

    Köbberling J, Trampisch H-J, Windeler J: Memorandum zur Evaluierung diagnostischer Methoden.Z Gastroenterol: 28:173–176, 1990

  9. 9.

    Pattrick FG: Investigation of gastroesophageal reflux in various positions with a two lumen pH electrode.GUT: 11:659–667, 1970

  10. 10.

    Johnson LF, DeMeester TR: 24-Hour pH-monitoring of the distal esophagus: a quantitative measure of gastroesophageal reflux.Am J Gastroenterol 62:325–332, 1974

  11. 11.

    Weiser HF, Pace F, Lepsien F, Müller-Lissner SA, Blum AL, Siewert JR: Gastroösophagealer Reflux: Was ist physiologisch?Dtsch Med Wochenschr 107:366–370, 1982

  12. 12.

    Murphy DW, Yuan Y, Castell DO: Does the intraoesophageal pH probe accurately detect acid reflux?Dig Dis Sci 34:649–656, 1989

  13. 13.

    Gustafsson PM, Tibbling L: 24-Hour oesophageal two-level pH-monitoring in healthy children and adolescents.Scand J Gastroenterol 23:91–94, 1988

  14. 14.

    Ball CS, Jenkinson LR, Watson A: Reproducibility of 24-hour oesophageal pH monitoring.Gut A723, 1988

  15. 15.

    Johnsson F, Joelsson B: Reproducibility of ambulatory oesophageal pH monitoring.Gut 29:886–889, 1988

  16. 16.

    Wiener GJ, Morgan TM, Cooper JB, Wu WC, Castell DO, Sinclair JW, Richter JE: Ambulatory 24-hour esophageal pH monitoring. Reproducibility and variability of pH parameters.Dig Dis Sci 33(9):1127–1133, 1988

  17. 17.

    Emde C, Garner A, Blum AL: Technical aspects of intraluminal pH-metry in man: current status and recommendations.Gut 28:1177–1188, 1987

  18. 18.

    DeMeester TR: Definition, detection, and pathophysiology of gastroesophageal reflux disease. In: De Meester TR, Matthews HR (eds):International Trends in General Thoracic Surgery, Vol 3.Benign Esophageal Disease. St. Louis: CV Mosby, 1987, pp 99–127

  19. 19.

    Schindlbeck NE, Heinrich Ch, König A, Dendorfer A, Pace F, Müller-Lissner St: Optimal thresholds, sensitivity and specificity of long-term pH-metry for the detection of gastroesophageal reflux disease.Gastroenterology 93:85–90, 1987

  20. 20.

    Fuchs KH, DeMeester RT, Albertucci M: Specificity and sensitivity of objective diagnosis of gastroesophageal reflux disease.Surgery 102(4):575–580, 1987

  21. 21.

    Vitale GC, Cheadle WG, Sadek S, Michel ME, Cuschieri A: Computerized 24-hour ambulatory esophageal pH monitoring and esophago-gastroduodenoscopy in the reflux patient.Ann Surg 200:724–738, 1984

  22. 22.

    Jorgensen F, Elsborg L, Hesse B: The diagnostic value of computerized short-term esophageal pH-monitoring in suspected gastro-esophageal reflux.Scand J Gastroenterol 23:363–368, 1988

  23. 23.

    Bollschweiler E, Hölscher AH: Wertigkeit verschiedener diagnostischer Verfahren bei der Refluxkrankheit—eine prospecktive klinische Untersuchung. In: Fuchs KH, Hamelmann H (eds.):Gastrointestinale Funktionsdiagnostik in der Chirurgie. Berlin: Blackwell, 1991, pp 75–85

  24. 24.

    Johnson R, Joelsson B, Gudmundsson K, Grieff L: Symptoms and endoscopic findings in the diagnosis of gastroesophageal reflux disease.Scand J Gastroenterol 22:714–718, 1987

  25. 25.

    Klauser A, Schindlbeck N, Müller-Lissner SA: Symptoms in gastroesophageal reflux disease.Lancet 335:205–208, 1990

  26. 26.

    Richter JR, Castell DO: Gastroesophageal reflux: pathogenesis, diagnosis and therapy.Ann Intern Med 97:93–103, 1982

  27. 27.

    Johansson KE, Boeryd B, Fransson SG, Tibbling L: Esophageal reflux tests, manometry, endoscopy, biopsy and radiology in healthy subjects.Scand J Gastroenterol 21:399–406, 1986

  28. 28.

    Bollschweiler E, Feussner H, Hoelscher AH, Siewert JR: Reflux-esophagitis: correlation between endoscopic classification and gastroesophageal reflux-pattern in 24-h pH-metry.Gastroenterology A756, 1989

  29. 29.

    Bollschweiler E, Hoelscher AH, Feussner H, Dittler HJ, Siewert JR: Classification of reflux-esophagitis according to the severity of gastroesophageal reflux-pattern in 24-h pH-metry. Book of Abstracts; The World Congresses of Gastroenterology, 1990, p 38

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Correspondence to E. Bollschweiler MD, PhD.

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Bollschweiler, E., Feussner, H., Hölscher, A.H. et al. pH monitoring: The gold standard in detection of gastrointestinal reflux disease?. Dysphagia 8, 118–121 (1993). https://doi.org/10.1007/BF02266991

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Key words

  • Gastroesophageal reflux disease
  • Diagnosis
  • pH monitoring
  • Diagnostic studies
  • Deglutition
  • Deglutition disorders