Normal Values of Pharyngeal and Esophageal 24-Hour pH Impedance in Individuals on and off Therapy and Interobserver Reproducibility Frank Zerbib, Sabine.

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Presentation transcript:

Normal Values of Pharyngeal and Esophageal 24-Hour pH Impedance in Individuals on and off Therapy and Interobserver Reproducibility Frank Zerbib, Sabine Roman, Stanislas Bruley Des Varannes, Guillaume Gourcerol, Benoît Coffin, Alain Ropert, Patricia Lepicard, François Mion Clinical Gastroenterology and Hepatology Volume 11, Issue 4, Pages 366-372 (April 2013) DOI: 10.1016/j.cgh.2012.10.041 Copyright © 2013 AGA Institute Terms and Conditions

Figure 1 Bifurcated esophageal and pharyngeal pH-impedance catheter. The long arm branch has 2 impedance electrode pairs positioned 3 and 5 cm above the EGJ and a pH sensor positioned 5 cm above the EGJ. The short arm branch has 4 impedance electrode pairs positioned 2 and 4 cm below the UES and 0 and 1 cm above the UES; a pH sensor is located 0.5 cm above the UES. Clinical Gastroenterology and Hepatology 2013 11, 366-372DOI: (10.1016/j.cgh.2012.10.041) Copyright © 2013 AGA Institute Terms and Conditions

Figure 2 Example of GER and PR events in a patient with heartburn and sore throat. Channels location related to EGJ or UES is indicated on the right. There is a drop in impedance starting distally (at the level of the EGJ) and reaching the more proximal pharyngeal impedance site. GER as well as PR events are acid (pH drops below 4). The vertical line corresponds to a heartburn episode. Clinical Gastroenterology and Hepatology 2013 11, 366-372DOI: (10.1016/j.cgh.2012.10.041) Copyright © 2013 AGA Institute Terms and Conditions

Figure 3 Examples of difficult analysis of pharyngeal impedance signals. (A) Liquid acid GER episode (arrow) with high proximal extent. After changing the time scale, the impedance drop in the pharyngeal channels was considered as a swallow. (B) Mixed acid GER event with high proximal extent and an impedance drop in the 2 pharyngeal channels initially considered as a swallow (black stars). After changing the time scale, this was considered as a PR. Clinical Gastroenterology and Hepatology 2013 11, 366-372DOI: (10.1016/j.cgh.2012.10.041) Copyright © 2013 AGA Institute Terms and Conditions