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Positioning of the ph-Probe by Manometry or Radiography for monitoring of the esophagus

Influence on diagnostic results?

Authors


Correspondence:Karin Aksglæde, Motility Laboratory, Department of Radiology R, Aarhus University Hospital, Nørrebrogade 44, DK-8000 Aarhus C, Denmark.
FAX +45 89 49 44 16.
E-mail: kbaks@akh.aaa.dk

Abstract

Purpose:  To correlate gastroesophageal reflux (GER), demonstrated by radiography using bread and barium, with 24-h pH monitoring in the esophagus, with the pH-probe positioned by manometry or radiology.

Material and Methods:  In all, 146 patients, 41 females and 105 males, with a median age of 47 years, suspected of GER were examined. Radiography was performed with the patient in the supine right oblique position during mastication and swallowing a piece of rye bread with liver pâté and barium. The test was positive if barium was observed more than 5 cm proximal to the gastroesophageal junction (GEJ). An antimony pH-probe was placed 5 cm above the lower esophageal sphincter determined by manometry, or 5 cm above the GEJ determined by radiography. The total time of esophageal pH < 4 exceeding 5% was considered pathological.

Results:  The radiological method had a specificity of 100% and a sensitivity of 52% compared to 24-h pH monitoring with the pH-probe positioned manometrically, and a specificity of 100% and sensitivity of 67% with the pH-probe positioned by radiography, with no significant difference between the two positionings.

Conclusion:  In 146 patients submitted to 24-h pH monitoring, the pH-probe could be placed as safely by radiography as by manometry.

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