Comparison of esophageal acid exposure at 1 cm and 6 cm above the squamocolumnar junction using the Bravo™ pH monitoring system

J. E. Pandolfino*, T. J. Lee, M. A. Schreiner, Q. Zhang, M. P. Roth, P. J. Kahrilas

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

33 Scopus citations

Abstract

The aim of this study was to assess the quantitative differences of acid exposure at 1 cm and 6 cm above the squamocolumnar junciton (SCJ) using two radiotelemetry pH capsules affixed to the esophageal mucosa. Ten normal subjects and 10 endoscopy-negative gastroesophageal reflux disease (GERD) patients without hiatus hernia (ages 20-54, 12 male) were studied for a 24-h period using the Bravo™ pH monitoring system. pH capsules were placed 1 cm and 6 cm above the SCJ. Interpretable data for at least 14 h was obtained in 18 of the 20 subjects (9 normal, 9 GERD). Two failures occurred secondary to early capsule dislodgement. Median esophageal acid exposure was significantly increased at 1 m above the SCJ compared to 6 cm above the SCJ during the total, upright and postprandial time periods in both normal and GERD subjects. During a 2 h postprandial period the esophageal acid exposure was 8-fold greater in GERD subjects and 5-fold greater in normal subjects 1 m above the SCJ compared to 6 cm above the SCJ. Confident measurement of esophageal acid exposure at a fixed position 1 cm above the SCJ is feasible with the Bravo system. Acid exposure was significantly higher 1 cm above the SCJ compared to 6 cm above the SCJ in both GERD patients and controls. These findings suggest that measurement of acid exposure 1 cm above the SCJ may improve accuracy of pH monitoring by detecting acid reflux events confined to the distal esophagus.

Original languageEnglish (US)
Pages (from-to)177-182
Number of pages6
JournalDiseases of the Esophagus
Volume19
Issue number3
DOIs
StatePublished - Jun 2006

Keywords

  • Bravo™ pH system
  • GERD
  • Radiotelemetry pH capsule
  • Squamocolumnar junction
  • pH monitoring

ASJC Scopus subject areas

  • Gastroenterology

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