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Abulatory Esophageal pH Monitoring

A Comparison of Two Methods of pH Capsule Placement

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Osowo, Ayodele T., M.B.B.S.; Jeevanantham, Vindh, M.B.B.S., M.P.H.; Kothari, Tarun, F.A.C.P.

American Journal of Gastroenterology: September 2005 - Volume 100 - Issue - p S25–S26
Supplement Abstracts Submitted for the 70th Annual Scientific Meeting of the American College of Gastroenterology: ESOPHAGUS
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Medicine, Unity Health System (Park Ridge Hospital), Rochester, NY and Gastroenterology, Unity Health System (Park Ridge Hospital), Rochester, NY.

Purpose: To see if the standard method by blind placement and a new method of placement under direct endoscopic visualization have similar outcomes.

Methods: A retrospective study was done by collection of data from the charts of all the patients who had capsule esophageal pH monitoring at Park Ridge Hospital between January and May 2005. The Bravo pH system was used on all patients. Failure was defined as non-attachment of the pH capsule to the esophagus. Data on demographic variables and comorbidities were collected.

Results: The mean age of the total sample (N = 36) was 45.4 ± 13.7 years. 69.4% were women. 94% were Caucasians and 5.6% African Americans. 44.4% had prior diagnosis of GERD, 86.1% were on a PPI (proton Pump inhibitor) prior to study. 22% had normal endoscopic findings, 44.4% had hiatal hernia, 11.1% had esophagitis and 11.1% had gastritis. 50% had non-gastrointestinal indications for pH monitoring such as cough, hoarseness of voice and atypical chest pain. 52.8% had pH capsule placed by the new method 2 and the mean duration was 8.72 ± 3.72minutes. 47.2% had the standard method 1 with a mean duration of 17.8 ± 16.64 minutes. The difference in duration of both methods is 9.03 minutes (P = 0.07). There was no re-attempt in method 2 and three in method 1 (P = 0.052). There was one failure in method 2 and three failures in method 1(P = 0.208).

Conclusions: This data suggests that placement of capsule under direct endoscopic visualization has a better outcome as measured by the lesser duration, number of attempts and failure rate. These differences were not statistically significant probably due to the small sample size. A large randomized prospective study is planned to confirm these findings.

© The American College of Gastroenterology 2005. All Rights Reserved.