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Reflux patterns in patients with short-segment Barrett's oesophagus: a study using impedance-pH monitoring off and on proton pump inhibitor therapy |
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| Authors: | M. FRAZZONI,E. SAVARINO&dagger ,M. MANNO,G. MELOTTI&Dagger ,V. G. MIRANTE,A. MUSSETTO,H. BERTANI,R. MANTA,& R. CONIGLIARO |
| Affiliation: | Gastroenterologia - Nuovo Ospedale S. Agostino, Modena, Italy;;Dipartimento di Medicina Interna - Universitàdi Genova, Genova, Italy;;Chirurgia Generale - Nuovo Ospedale S. Agostino, Modena, Italy |
| Abstract: | Background In short-segment Barrett's oesophagus (SSBO) heartburn may be absent and oesophageal acid exposure time (OAET) assessed with pH-only monitoring may be normal. By detecting reflux episodes independently of their acidity, multichannel intraluminal impedance-pH (MII-pH) monitoring allows a comprehensive characterization of reflux events, either off or on proton pump inhibitor (PPI) therapy. Aim To assess reflux parameters by MII-pH monitoring in newly diagnosed SSBO, at baseline and as modified with PPI therapy. Methods Short-segment Barrett's oesophagus was defined by oesophageal intestinal metaplasia up to 3 cm in length. 24-h MII-pH monitoring was performed before and during PPI therapy. Results Fifty patients were studied prospectively. Normal OAET was found at baseline in 15 patients (30%), 8 and 2 of whom with a higher than normal number of acid and weakly acidic refluxes, respectively. Overall, abnormal reflux parameters were detected by MII-pH monitoring in 90% of patients. Reflux events were prevalent in the upright period. On PPI therapy, acid refluxes decreased and a correspondent increase in weakly acidic refluxes was observed (median from 48.5 to 9 and from 16 to 57.5, respectively) ( P < 0.001). Conclusions Acid refluxes, mainly in the upright period, characterize SSBO. PPI therapy transforms acid refluxes into weakly acidic refluxes. |
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