Korean J Gastroenterol.  2017 Oct;70(4):169-175. 10.4166/kjg.2017.70.4.169.

The Additional Role of Symptom-Reflux Association Analysis of Diagnosis of Gastroesophageal Reflux Disease Using Bravo Capsule pH Test

• Jung K
• Park MI
• Park SJ
• Moon W
• Kim SE
• Kim JH

• KMID: 2392912
• DOI: http://doi.org/10.4166/kjg.2017.70.4.169

Abstract

BACKGROUND/AIMS
Since the development of ambulatory esophageal pH monitoring test to diagnose gastroesophageal reflux disease (GERD), several parameters have been introduced. The aim of this study was to assess whether using the symptom index (SI), symptom sensitivity index (SSI), and symptom association probability (SAP), in addition to the DeMeester score (DS), would be useful for interpreting the Bravo pH monitoring test.
METHODS
A retrospective study, which included 68 patients with reflux symptoms refractory to proton pump inhibitor (PPI) therapy who underwent a Bravo capsule pH test between October 2006 and May 2015, was carried out. Acid reflux parameters and symptom reflux association parameters were analyzed.
RESULTS
The median percent time of total pH<4 and DS were 2.90% (interquartile range [IQR] 1.13-6.03%) and 11.10 (IQR 4.90-22.80), respectively. According to the analysis of the day-to-day variation in percent time of total pH<4 (r=0.724) and DS (r=0.537), there was a significant correlation between Day 1 and Day 2. The positive rate of Bravo test according to DS was 27 (39.7%). Although thirty patients experienced symptoms during the test, there were no significant differences of reflux parameters compared with other patients. In the symptom group, 7 patients (23.3%) were identified as having negative DS and an abnormal symptom-related index. There were no significant test-related complications.
CONCLUSIONS
In addition to the analysis of traditional acid parameters of the Bravo capsule pH test, diagnosis of GERD, including reflux hypersensitivity, can be improved by performing an analysis of the symptom-reflux association and of the day-to-day variation.

Keyword

Bravo capsule pH test; Gastroesophageal reflux disease; Symptom-reflux association

MeSH Terms

Diagnosis*
Esophageal pH Monitoring
Gastroesophageal Reflux*
Humans
Hydrogen-Ion Concentration*
Hypersensitivity
Proton Pumps
Retrospective Studies
Proton Pumps

Figure

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  Fig. 1. Flow chart of patients. PPI, proton pump inhibitor.

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  Fig. 2. Correlation between Day 1 and Day 2 of the Bravo capsule pH test. (A) There was positive correlation between % time pH<4 of Day 1 and Day 2 (r=0.724, p<0.01). (B) There was positive correlation between DeMeester score of Day 1 and Day 2 (r=0.537, p<0.01). Coefficient of determination (R2) was calculated by linear regression.

Reference

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