esophageal ph monitoring


Summary: Analysis of the HYDROGEN ION CONCENTRATION in the lumen of the ESOPHAGUS. It is used to record the pattern, frequency, and duration of GASTROESOPHAGEAL REFLUX.

Top Publications

  1. Maher M, Darwish A. Study of respiratory disorders in endoscopically negative and positive gastroesophageal reflux disease. Saudi J Gastroenterol. 2010;16:84-9 pubmed publisher
    ..There is direct relationship between the severity of airways obstruction as detected by FEV1 and FEV1/FVC and GER symptoms. ..
  2. Domingues G, Moraes Filho J, Domingues A. Impact of prolonged 48-h wireless capsule esophageal pH monitoring on diagnosis of gastroesophageal reflux disease and evaluation of the relationship between symptoms and reflux episodes. Arq Gastroenterol. 2011;48:24-9 pubmed
    ..4%. Esophageal pH monitoring with wireless capsule is safe, well tolerated, does not require sedation...
  3. Grigolon A, Consonni D, Bravi I, Tenca A, Penagini R. Diagnostic yield of 96-h wireless pH monitoring and usefulness in patients' management. Scand J Gastroenterol. 2011;46:522-30 pubmed publisher
    ..Outcome was however similar to the one of traditional pH monitoring. ..
  4. Sweis R, Fox M, Anggiansah A, Wong T. Prolonged, wireless pH-studies have a high diagnostic yield in patients with reflux symptoms and negative 24-h catheter-based pH-studies. Neurogastroenterol Motil. 2011;23:419-26 pubmed publisher
    ..Without a definitive diagnosis, many would not have received effective treatment. ..
  5. Broeders J, Bredenoord A, Hazebroek E, Broeders I, Gooszen H, Smout A. Effects of anti-reflux surgery on weakly acidic reflux and belching. Gut. 2011;60:435-41 pubmed publisher
    ..It can be hypothesised that the reduction in GBs after LNF incites patients to increase SGBs in a futile attempt to vent air from the stomach. ..
  6. Hemmink G, Bredenoord A, Aanen M, Weusten B, Timmer R, Smout A. Computer analysis of 24-h esophageal impedance signals. Scand J Gastroenterol. 2011;46:271-6 pubmed publisher
    ..Although not as good as manual analysis by experts, computer analysis can be a helpful tool to identify reflux episodes and to assess the relationship between reflux episodes and symptoms. ..
  7. Pilic D, Fröhlich T, Nöh F, Pappas A, Schmidt Choudhury A, Kohler H, et al. Detection of gastroesophageal reflux in children using combined multichannel intraluminal impedance and pH measurement: data from the German Pediatric Impedance Group. J Pediatr. 2011;158:650-654.e1 pubmed publisher
    ..Our findings confirm that MII-pH is superior to pH monitoring alone in detecting GER. ..
  8. Lacy B, Dukowicz A, Robertson D, Weiss J, Teixeira P, Kelley M. Clinical utility of the wireless pH capsule. J Clin Gastroenterol. 2011;45:429-35 pubmed publisher
    ..Future studies should define specific test characteristics most likely to influence patient care. ..
  9. Chander B, Hanley Williams N, Deng Y, Sheth A. 24 Versus 48-hour bravo pH monitoring. J Clin Gastroenterol. 2012;46:197-200 pubmed publisher
    ..A retrospective chart review of 124 consecutive patients who underwent 48-hour wireless esophageal pH monitoring studies was prepared...

More Information


  1. Rosen R, Levine P, Lewis J, Mitchell P, Nurko S. Reflux events detected by pH-MII do not determine fundoplication outcome. J Pediatr Gastroenterol Nutr. 2010;50:251-5 pubmed publisher
    ..pH-multichannel intraluminal impedance testing may not be a useful tool in predicting fundoplication outcome. ..
  2. Dent J, Vakil N, Jones R, Bytzer P, Schöning U, Halling K, et al. Accuracy of the diagnosis of GORD by questionnaire, physicians and a trial of proton pump inhibitor treatment: the Diamond Study. Gut. 2010;59:714-21 pubmed publisher
    ..The RDQ, family practitioners and gastroenterologists have moderate and similar accuracy for diagnosis of GORD. Symptom response to a 2 week course of 40 mg of esomeprazole does not add diagnostic precision. ..
  3. Bradley A, Crowell M, DiBaise J, Kim H, Burdick G, Fleischer D, et al. Comparison of the impact of wireless versus catheter-based pH-metry on daily activities and study-related symptoms. J Clin Gastroenterol. 2011;45:100-6 pubmed publisher
    ..This information may be useful in helping to decide which patients should undergo the wireless pH-metry or receive additional counseling on procedural expectations. ..
  4. Savarino E, Marabotto E, Zentilin P, Frazzoni M, Sammito G, Bonfanti D, et al. The added value of impedance-pH monitoring to Rome III criteria in distinguishing functional heartburn from non-erosive reflux disease. Dig Liver Dis. 2011;43:542-7 pubmed publisher
  5. Kessing B, Govaert F, Masclee A, Conchillo J. Impedance measurements and high-resolution manometry help to better define rumination episodes. Scand J Gastroenterol. 2011;46:1310-5 pubmed publisher
  6. Kessing B, Bredenoord A, Weijenborg P, Hemmink G, Loots C, Smout A. Esophageal acid exposure decreases intraluminal baseline impedance levels. Am J Gastroenterol. 2011;106:2093-7 pubmed publisher
    ..The aim of this study was to investigate the baseline impedance in GERD patients, on and off proton pump inhibitor (PPI), and in healthy controls...
  7. Hemmink G, Bredenoord A, Weusten B, Monkelbaan J, Timmer R, Smout A. Esophageal pH-impedance monitoring in patients with therapy-resistant reflux symptoms: 'on' or 'off' proton pump inhibitor?. Am J Gastroenterol. 2008;103:2446-53 pubmed publisher
  8. Aanen M, Bredenoord A, Samsom M, Smout A. Reliability of oesophageal pH recording for the detection of gastro-oesophageal reflux. Scand J Gastroenterol. 2008;43:1442-7 pubmed publisher
    ..Decreases from above to below 4 with cut-offs between > or =0.5 and < or =3.3 are the most indicative of true reflux episodes. ..
  9. Zimmerman J, Hershcovici T. Bowel symptoms in nonerosive gastroesophageal reflux disease: nature, prevalence, and relation to acid reflux. J Clin Gastroenterol. 2008;42:261-5 pubmed publisher
    ..3) The presence of IBS features in a large proportion of NERD patients reflects a high prevalence of visceral hypersensitivity that may aggravate acid reflux symptoms. ..
  10. Malhotra A, Freston J, Aziz K. Use of pH-impedance testing to evaluate patients with suspected extraesophageal manifestations of gastroesophageal reflux disease. J Clin Gastroenterol. 2008;42:271-8 pubmed publisher
    ..It also distinguishes between reflux due to acid, nonacid, and gas, with consequences for management. ..
  11. Fass R, Naliboff B, Fass S, Peleg N, Wendel C, Malagon I, et al. The effect of auditory stress on perception of intraesophageal acid in patients with gastroesophageal reflux disease. Gastroenterology. 2008;134:696-705 pubmed publisher
    ..Acute auditory stress can exacerbate heartburn symptoms in GERD patients by enhancing perceptual response to intraesophageal acid exposure. This greater perceptual response is associated with greater emotional responses to the stressor. ..
  12. Gunnarsdottir A, Stenstrom P, Arnbjornsson E. 48-hour wireless oesophageal pH-monitoring in children: are two days better than one?. Eur J Pediatr Surg. 2007;17:378-81 pubmed
    ..Individual variations were noted but had no clinical significance except in two patients. Our results support the use of pH-measurement for a period of 24 hours only. ..
  13. Oelschlager B, Quiroga E, Isch J, Cuenca Abente F. Gastroesophageal and pharyngeal reflux detection using impedance and 24-hour pH monitoring in asymptomatic subjects: defining the normal environment. J Gastrointest Surg. 2006;10:54-62 pubmed
    ..Thus, traditional 24-hour pH monitoring may underestimate the presence of pharyngeal reflux. The combination of impedance with pH monitoring markedly enhances our ability to accurately detect potential microaspiration. ..
  14. Atalay F, Dagli U, Kuran S, Ozin Y, Ernam D, Sahin B. Does acid reflux cause pulmonary disease?. Turk J Gastroenterol. 2005;16:199-202 pubmed
    ..There are no data to answer the question of whether or not reflux precedes onset of cough/asthma. Better-designed prospective cohort studies may provide further insight. ..
  15. Draaisma W, Rijnhart De Jong H, Broeders I, Smout A, Furnee E, Gooszen H. Five-year subjective and objective results of laparoscopic and conventional Nissen fundoplication: a randomized trial. Ann Surg. 2006;244:34-41 pubmed
    ..A substantial minority of patients in both groups had a second antireflux operation or took antisecretory drugs, although the use of those medications did not appear to be related to abnormal esophageal acid exposure. ..
  16. Tutuian R, Castell D. Review article: complete gastro-oesophageal reflux monitoring - combined pH and impedance. Aliment Pharmacol Ther. 2006;24 Suppl 2:27-37 pubmed
    ..We believe that MII-pH monitoring has become the new ''gold standard'' for clarifying the mechanisms of persistent symptom on PPI therapy. ..
  17. Marchese M, Spada C, Iacopini F, Familiari P, Shah S, Tringali A, et al. Nonendoscopic transnasal placement of a wireless capsule for esophageal pH monitoring: feasibility, safety, and efficacy of a manometry-guided procedure. Endoscopy. 2006;38:813-8 pubmed
    ..the safety, feasibility, and efficacy of transnasal placement of the Medtronic Bravo capsule for wireless esophageal pH monitoring. Forty patients with symptomatic gastroesophageal reflux disease were prospectively evaluated...
  18. Bechtold M, Holly J, Thaler K, Marshall J. Bravo (wireless) ambulatory esophageal pH monitoring: how do day 1 and day 2 results compare?. World J Gastroenterol. 2007;13:4091-5 pubmed
    ..A retrospective study of 27 consecutive adult patients who underwent Bravo esophageal pH monitoring was performed. Patients underwent EGD under IV conscious sedation prior to Bravo placement...
  19. Wasko Czopnik D, Błoński W, Paradowski L. Diagnostic difficulties during combined multichannel intraluminal impedance and pH monitoring in patients with esophagitis or Barrett's esophagus. Adv Med Sci. 2007;52:196-8 pubmed
    ..Therefore, future studies are needed to further evaluate this problem. ..
  20. Lee Y, Wang H, Chiu H, Huang S, Tu C, Wu M, et al. Patients with functional heartburn are more likely to report retrosternal discomfort during wireless pH monitoring. Gastrointest Endosc. 2005;62:834-41 pubmed
    ..Capsule-induced retrosternal discomfort in the presence of normal acid exposure suggests functional heartburn. ..
  21. Ahlawat S, Novak D, Williams D, Maher K, Barton F, Benjamin S. Day-to-day variability in acid reflux patterns using the BRAVO pH monitoring system. J Clin Gastroenterol. 2006;40:20-4 pubmed
    ..It is an acceptable alternative for patients who are unwilling or unable to tolerate nasopharyngeal catheter-based pH studies, and it has a potential advantage of the 2-day recording period. ..
  22. Kim G, Kang D, Song G, Kim T, Heo J, Cho M, et al. Gastroesophageal flap valve is associated with gastroesophageal and gastropharyngeal reflux. J Gastroenterol. 2006;41:654-61 pubmed
    ..001). Endoscopic grading of the GEFV is easy and provides useful information about the status of gastroesophageal and gastropharyngeal reflux. ..
  23. Wu J, Mui L, Cheung C, Chan Y, Sung J. Obesity is associated with increased transient lower esophageal sphincter relaxation. Gastroenterology. 2007;132:883-9 pubmed
    ..We evaluated the association between obesity and function of lower esophageal sphincter (LOS) in subjects without GERD...
  24. Fox M, Barr C, Nolan S, Lomer M, Anggiansah A, Wong T. The effects of dietary fat and calorie density on esophageal acid exposure and reflux symptoms. Clin Gastroenterol Hepatol. 2007;5:439-44 pubmed
    ..A catheter-free system provided esophageal pH monitoring over 4 days in 4 dietary conditions...
  25. Ayazi S, Lipham J, Portale G, Peyre C, Streets C, Leers J, et al. Bravo catheter-free pH monitoring: normal values, concordance, optimal diagnostic thresholds, and accuracy. Clin Gastroenterol Hepatol. 2009;7:60-7 pubmed publisher
    ..An abnormal composite pH score, obtained in either the first or second 24-hour recording period, was the most accurate method of identifying patients with GERD. ..
  26. Conchillo J, Smout A. Review article: intra-oesophageal impedance monitoring for the assessment of bolus transit and gastro-oesophageal reflux. Aliment Pharmacol Ther. 2009;29:3-14 pubmed publisher
  27. Mezzacappa M, Rosa A. Clinical predictors of abnormal esophageal pH monitoring in preterm infants. Arq Gastroenterol. 2008;45:234-8 pubmed
    ..Bronchopulmonary dysplasia and use of caffeine were not associated with reflux index > or = 10%. ..
  28. Sarnelli G, De Giorgi F, Efficie E, Aprea G, Masone S, Savarese M, et al. Correlation between oesophageal acid exposure and dyspeptic symptoms in patients with nonerosive reflux disease. Eur J Gastroenterol Hepatol. 2008;20:264-8 pubmed publisher
    ..33/43, respectively, P=NS). Dyspeptic symptoms coexist in a subset of nonerosive reflux disease patients, but prevalence and severity of the symptoms seems to be independent of oesophageal acid exposure. ..
  29. Lee W, Yeh Y, Lacy B, Pandolfino J, Brill J, Weinstein M, et al. Timely confirmation of gastro-esophageal reflux disease via pH monitoring: estimating budget impact on managed care organizations. Curr Med Res Opin. 2008;24:1317-27 pubmed
    ..Timely and increased use of pH monitoring as recommended in published guidelines leads to less unnecessary use of PPIs with a modest budgetary impact on health plans. ..
  30. Remes Troche J, Ibarra Palomino J, Carmona Sánchez R, Valdovinos M. Performance, tolerability, and symptoms related to prolonged pH monitoring using the Bravo system in Mexico. Am J Gastroenterol. 2005;100:2382-6 pubmed
    ..Women and younger patients had more symptoms related to the procedure (p < 0.05). Esophageal pH monitoring with Bravo capsule is a safe, reliable, and tolerable method in patients with GERD.
  31. Rijnhart De Jong H, Draaisma W, Smout A, Broeders I, Gooszen H. The Visick score: a good measure for the overall effect of antireflux surgery?. Scand J Gastroenterol. 2008;43:787-93 pubmed publisher
  32. Chen C, Orr W. Analysis of 24-hour esophageal pH monitoring: the effect of state of consciousness. Curr Gastroenterol Rep. 2008;10:258-62 pubmed
    ..addresses current advances in the diagnosis of sleep-related gastroesophageal reflux using ambulatory esophageal pH monitoring and laboratory monitoring, which includes polygraphic assessment of the state of consciousness...
  33. Ross S, Villadolid D, Paul H, Al Saadi S, Gonzalez J, Cowgill S, et al. Laparoscopic Nissen fundoplication ameliorates symptoms of reflux, especially for patients with very abnormal DeMeester scores. Am Surg. 2008;74:635-42; discussion 643 pubmed
    ..Relief of excessive acid reflux, regardless of severity or degree (i.e., DeMeester scores), ameliorates symptoms of acid reflux thereby encouraging fundoplication, especially for patients with very abnormal DeMeester scores. ..
  34. Reichel O, Issing W. Impact of different pH thresholds for 24-hour dual probe pH monitoring in patients with suspected laryngopharyngeal reflux. J Laryngol Otol. 2008;122:485-9 pubmed
    ..Further studies with a larger number of healthy volunteers are necessary in order to reveal normative values for the reflux area index five parameter. ..
  35. Semeniuk J, Kaczmarski M. 24-hour esophageal pH-monitoring in children suspected of gastroesophageal reflux disease: analysis of intraesophageal pH monitoring values recorded in distal and proximal channel at diagnosis. World J Gastroenterol. 2007;13:5108-15 pubmed
    ..24-h esophageal pH monitoring confirmed pathological acid GER in 52.3% of children with typical and atypical symptoms of GERD...
  36. Yigit T, Quiroga E, Oelschlager B. Multichannel intraluminal impedance for the assessment of post-fundoplication dysphagia. Dis Esophagus. 2006;19:382-8 pubmed
    ..Esophageal clearance is impaired in the majority of patients with postoperative dysphagia, even with normal fundoplication anatomy and normal peristalsis. MII may detect disorders in esophageal motility not detected by manometry. ..
  37. Ayazi S, Hagen J, Chan L, Demeester S, Lin M, Ayazi A, et al. Obesity and gastroesophageal reflux: quantifying the association between body mass index, esophageal acid exposure, and lower esophageal sphincter status in a large series of patients with reflux symptoms. J Gastrointest Surg. 2009;13:1440-7 pubmed publisher
    ..The aim of this study is to quantify the relationship between body mass index (BMI) and 24-h esophageal pH measurements and the status of the lower esophageal sphincter (LES) in patients with reflux symptoms...
  38. Calabrese F, Rizzo S, Giacometti C, Panizzolo C, Turato G, Snijders D, et al. High viral frequency in children with gastroesophageal reflux-related chronic respiratory disorders. Pediatr Pulmonol. 2008;43:690-6 pubmed publisher
    ..41%, P = 0.01). Rhinovirus and respiratory syncytial virus were the principal detected viruses in the aspirator group. Viral infections could play a key role in the pathogenesis of GER-related CRDs. ..
  39. Håkanson B, Berggren P, Granqvist S, Ljungqvist O, Thorell A. Comparison of wireless 48-h (Bravo) versus traditional ambulatory 24-h esophageal pH monitoring. Scand J Gastroenterol. 2009;44:276-83 pubmed publisher
  40. Savarino E, Zentilin P, Tutuian R, Pohl D, Casa D, Frazzoni M, et al. The role of nonacid reflux in NERD: lessons learned from impedance-pH monitoring in 150 patients off therapy. Am J Gastroenterol. 2008;103:2685-93 pubmed publisher
    ..Monitoring for nonacid reflux in NERD patients reduces the proportion of patients classified as having "functional heartburn." Studies assessing the clinical implications of these findings are warranted. ..
  41. Goessler A, Huber Zeyringer A, Hoellwarth M. Does epilepsy influence the outcome of antireflux procedures in neurologically impaired children?. Pediatr Surg Int. 2006;22:485-90 pubmed
    ..We consider our findings to strongly question the widespread opinion considering this correlation. We conclude, that cerebral seizures alone do not alter the operative outcome of antireflux surgery in NIP. ..
  42. Calabrese C, Liguori G, Gabusi V, Gionchetti P, Rizzello F, Straforini G, et al. Ninety-six-hour wireless oesophageal pH monitoring following proton pump inhibitor administration in NERD patients. Aliment Pharmacol Ther. 2008;28:250-5 pubmed publisher
    ..Omeprazole, pantoprazole and lansoprazole have an equivalent potency for normalizing intra-oesophageal acid exposure after 3 days of treatment in non-erosive reflux disease patients. ..
  43. Kim K, Kim G, Kim D, Wang S, Lee B, Lee J, et al. Is ineffective esophageal motility associated with gastropharyngeal reflux disease?. World J Gastroenterol. 2008;14:6030-5 pubmed
    ..There was no association between IEM and GPRD as well as between IEM and GERD. IEM alone cannot be considered as a definitive marker for reflux disease. ..
  44. Pohl D, Tutuian R. Reflux monitoring: pH-metry, Bilitec and oesophageal impedance measurements. Best Pract Res Clin Gastroenterol. 2009;23:299-311 pubmed publisher
    ..The present review summarises the technical aspects in performing and interpreting esophageal reflux monitoring procedures. ..
  45. Gasiorowska A, Navarro Rodriguez T, Wendel C, Krupinski E, Perry Z, Koenig K, et al. Comparison of the degree of duodenogastroesophageal reflux and acid reflux between patients who failed to respond and those who were successfully treated with a proton pump inhibitor once daily. Am J Gastroenterol. 2009;104:2005-13 pubmed publisher
    ..GERD symptoms in the PPI failure group are more commonly associated with acid reflux than with DGER. ..
  46. Fortunato G, Machado M, Andrade C, Felicetti J, Camargo J, Cardoso P. Prevalence of gastroesophageal reflux in lung transplant candidates with advanced lung disease. J Bras Pneumol. 2008;34:772-8 pubmed
    ..In the population studied, digestive symptoms of GER were not predictive of pathological acid reflux. The role that GER plays in chronic rejection should be examined and clarified in future studies. ..
  47. Loots C, Benninga M, Davidson G, Omari T. Addition of pH-impedance monitoring to standard pH monitoring increases the yield of symptom association analysis in infants and children with gastroesophageal reflux. J Pediatr. 2009;154:248-52 pubmed publisher
    ..Including all MII-detected bolus GER and excluding pH-only GER for analysis optimizes the yield of GER-symptom associations in infants and children. ..
  48. Garrean C, Zhang Q, Gonsalves N, Hirano I. Acid reflux detection and symptom-reflux association using 4-day wireless pH recording combining 48-hour periods off and on PPI therapy. Am J Gastroenterol. 2008;103:1631-7 pubmed publisher
    Studies have shown that extended pH recording improves the sensitivity of esophageal pH monitoring. Controversy exists as to whether pH studies are optimally done off or on proton pump inhibitor (PPI) therapy...
  49. Zerbib F, Roman S, Ropert A, des Varannes S, Pouderoux P, Chaput U, et al. Esophageal pH-impedance monitoring and symptom analysis in GERD: a study in patients off and on therapy. Am J Gastroenterol. 2006;101:1956-63 pubmed
    ..The impact of this improved diagnostic value on gastroesophageal reflux disease management remains to be investigated by outcome studies. ..
  50. Ayazi S, Lipham J, Hagen J, Tang A, Zehetner J, Leers J, et al. A new technique for measurement of pharyngeal pH: normal values and discriminating pH threshold. J Gastrointest Surg. 2009;13:1422-9 pubmed publisher
    ..All subjects underwent esophagram, esophageal manometry, upper and lower esophageal pH monitoring with a dual-channel pH catheter and pharyngeal pH monitoring with the new probe...
  51. Pritchett J, Aslam M, Slaughter J, Ness R, Garrett C, Vaezi M. Efficacy of esophageal impedance/pH monitoring in patients with refractory gastroesophageal reflux disease, on and off therapy. Clin Gastroenterol Hepatol. 2009;7:743-8 pubmed publisher
    ..026). Abnormal impedance in patients on therapy predicts acid reflux in patients off therapy. In patients with refractory reflux, combined impedance/pH monitoring might provide the single best strategy for evaluation of reflux symptoms. ..
  52. Sweis R, Fox M, Anggiansah R, Anggiansah A, Basavaraju K, Canavan R, et al. Patient acceptance and clinical impact of Bravo monitoring in patients with previous failed catheter-based studies. Aliment Pharmacol Ther. 2009;29:669-76 pubmed publisher
    ..Tolerance and satisfaction with catheter-free pH monitoring are high in patients who had previously failed C-pH; catheter-free pH monitoring assists the definitive diagnosis of GERD in this group. ..
  53. Conchillo J, Schwartz M, Selimah M, Samsom M, Sifrim D, Smout A. Acid and non-acid reflux patterns in patients with erosive esophagitis and non-erosive reflux disease (NERD): a study using intraluminal impedance monitoring. Dig Dis Sci. 2008;53:1506-12 pubmed
    ..This observation lends support to the notion that non-acid reflux is less damaging to the esophageal mucosa than acid reflux. ..