Moschos J, Kouklakis G, Leontiadis G, Koulaouzidis A, Kadis S, Mpoumponaris A, Molyvas E, Minopoulos G.
3-hour postprandial ph monitoring study correlation with Endoscopy in Gastroesophageal Reflux Disease.
J Coll Physicians Surg Pak Jan ;17(3):180-1.

The aim was to correlate the findings of endoscopy and pH monitoring. Sixty patients with attacks of heartburn, at least weekly, for a period no less than one year were screened with endoscopy. Forty-seven patients; 24 males and 23 females, mean age 40.8 (13.7) years, were found to have erosive oesophagitis or Barrett`s oesophagus (BO) and underwent 3-hour postprandial pH monitoring. All patients were advised to stop acid suppression therapy (4 days beforehand for those taking antacids and 15 days beforehand for those using H2-RA or PPIs). Endoscopy was performed using the Fujinon EPX-201 endoscope system (Fujinon Optical Tokyo, Japan). The presence of oesophagitis was graded according to Los Angeles (LA) classification system. The diagnosis of BO was established by performing several biopsies every 2 cm. On a different day and after an overnight fast, oesophageal manometry was performed using a 4-channel, silicone rubber, low compliance, perfused manometric assembly (Manometric pump-model PIP-4-8SS Mui Scientific). Three-hour postprandial (standardized breakfast) ambulatory oesophageal pH monitoring study was carried out (PHmetry UPS 2020, MMS- Medical Measurement Systems BV). Reflux was defined as a pH less than 4 and reflux time as the duration of episodes with pH of less than 4. The DeMeester score, whose rate was the base of the correlation between the subjects, was estimated postprandially for a 3-hour period. Forty-seven consecutive patients were identified with erosive oesophagitis and/or BO. All consented to be included in the study. All 47 patients were able to complete the test and had DeMeester score of over 14.72 (abnormal pH monitoring). Nineteen out of 39 patients with oesophagitis had grade A oesophagitis and the average of the DeMeester score was 35.00. Eighteen out of 39 patients with oesophagitis had grade B oesophagitis and the average of the DeMeester score was 49.37. Two out of 39 patients with oesophagitis had grade C oesophagitis and the average of the DeMeester score was 77.88 (Figure 1). A very significant correlation was found between the grade of oesophagitis and DeMeester score (Spearman`s rho=1.00, p <0.01). Eight patients had BO and the average of the DeMeester score was 44.55. It is of note that, 7 out of 8 patients (87.5%) with BO had hiatus hernia in endoscopy.

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