We have detected that you are using an Ad Blocker.
PracticeUpdate is free to end users but we rely on advertising to fund our site. Please consider supporting PracticeUpdate by whitelisting us in your ad blocker.
We have sent a message to the email address you have provided, . If this email is not correct, please update your settings with your correct address.
The email address you provided during registration, , does not appear to be valid. Please update your settings with a valid address before to continue using PracticeUpdate.
Please provide your AHPRA Number to ensure that you are given the correct level of access to our site.
featured
Published in Gastroenterology

Expert Opinion / My Approach · January 21, 2015

MY APPROACH to pH Testing (Impedance vs Bravo)

Written by
Edoardo V. Savarino MD, PhD

 

Additional Info

  1. Kahrilas PJ. Gastroesophageal reflux disease. JAMA. 1996;276(12):983-988.
  2. Kahrilas PJ, Shaheen NJ, Vaezi MF; American Gastroenterological Association Institute; Clinical Practice and Quality Management Committee. American Gastroenterological Association Institute technical review on the management of gastroesophageal reflux disease. Gastroenterology. 2008;135(4):1392-1413;1413.e1-e5.
  3. Katz PO, Gerson LB, Vela MF. Guidelines for the diagnosis and management of gastroesophageal reflux disease. Am J Gastroenterol. 2013;108(3):308-328.
  4. Savarino E, Zentilin P, Savarino V. NERD: an umbrella term including heterogeneous subpopulations. Nat Rev Gastroenterol Hepatol. 2013;10(6):371-380.
  5. Savarino E, Zentilin P, Tutuian R, 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(11):2685-2693.
  6. Vakil N, van Zanten SV, Kahrilas P, Dent J, Jones R; Global Consensus Group. The Montreal definition and classification of gastroesophageal reflux disease: a global evidence-based consensus. Am J Gastroenterol. 2006;101(8):1900-1920; quiz 1943.
  7. Zentilin P, Savarino V, Mastracci L, et al. Reassessment of the diagnostic value of histology in patients with GERD, using multiple biopsy sites and an appropriate control group. Am J Gastroenterol. 2005;100(10):2299-2306.
  8. Savarino E, Zentilin P, Mastracci L, et al. Microscopic esophagitis distinguishes patients with non-erosive reflux disease from those with functional heartburn. J Gastroenterol. 2013;48(4):473-482.
  9. Pandolfino JE, Zhang Q, Schreiner MA, et al. Acid reflux event detection using the Bravo wireless versus the Slimline catheter pH systems: why are the numbers so different? Gut. 2005;54(12):1687-1692.
  10. des Varannes SB, Mion F, Ducrotte P, et al. Simultaneous recordings of oesophageal acid exposure with conventional pH monitoring and a wireless system (Bravo). Gut. 2005;54(12):1682-1686.
  11. Wong WM, Bautista J, Dekel R, et al. Feasibility and tolerability of transnasal/per-oral placement of the wireless pH capsule vs. traditional 24-h oesophageal pH monitoring: a randomized trial. Aliment Pharmacol Ther. 2005;21(2):155-163.
  12. Bhat YM, McGrath KM, Bielefeldt K. Wireless esophageal pH monitoring: new technique means new questions. J Clin Gastroenterol. 2006;40(2):116-121.
  13. Sifrim D, Castell D, Dent J, et al. Gastro-oesophageal reflux monitoring: review and consensus report on detection and definitions of acid, non-acid, and gas reflux. Gut. 2004;53(7):1024-1031.
  14. Bredenoord AJ, Weusten BLAM, Timmer R, et al. Addition of esophageal impedance monitoring to pH monitoring increases the yield of symptom association analysis in patients off PPI therapy. Am J Gastroenterol. 2006;101(3):453-459.
  15. Savarino E, Marabotto E, Zentilin P, 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(7):542-547.
  16. Savarino E, Pohl D, Zentilin P, et al. Functional heartburn has more in common with functional dyspepsia than with non-erosive reflux disease. Gut. 2009;58(9):1185-1191.
  17. Savarino E, Zentilin P, Frazzoni M, et al. Characteristics of gastro-esophageal reflux episodes in Barrett's esophagus, erosive esophagitis and healthy volunteers. Neurogastroenterol Motil. 2010;22(10):1061-e280.
  18. Kahrilas PJ, Sifrim D. High-resolution manometry and impedance-pH/manometry: valuable tools in clinical and investigational esophagology. Gastroenterology. 2008;135(3):756-769.
  19. Hemmink GJ, Bredenoord AJ , Weusten BL, et al. Esophageal pH-impedance monitoring in patients with therapy-resistant reflux symptoms: ‘on’ or ‘off’ proton pump inhibitor? Am J Gastroenterol. 2008;103(10):2446-2453.
  20. Pritchett JM, Aslam M, Slaughter JC, et al. Efficacy of esophageal impedance/pH monitoring in patients with refractory gastroesophageal reflux disease, on and off therapy. Clin Gastroenterol Hepatol. 2009;7(7):743-748.

Further Reading