Telemetry Capsule for Ambulatory pH Monitoring: Is It Time for a Change?

There is currently no clear gold standard for the diagnosis of gastroesophageal reflux disease. The most common practice, a therapeutic trial of antisecretory therapy, falls short of being ideal. Endoscopy is insensitive and impractical as an early diagnostic test for the majority of patient presentations. Ambulatory reflux monitoring offers the most effective means of documenting the presence of abnormal esophageal acid exposure and abnormal reflux frequency and to correlate the association of symptoms and reflux episodes. However, even this diagnostic test has fallen short of being an adequate and reliable standard for diagnosis. Telemetry capsule monitoring offers the opportunity for creative improvement in the diagnostic utility of pH monitoring and is the subject of the study discussed.

[1]  P. Höglund,et al.  Wireless pH Recording Immediately Above the Squamocolumnar Junction Improves the Diagnostic Performance of Esophageal pH Studies , 2008, The American Journal of Gastroenterology.

[2]  J. Johansson,et al.  Optimal Thresholds and Discriminatory Power of 48-h Wireless Esophageal pH Monitoring in the Diagnosis of GERD , 2007, The American Journal of Gastroenterology.

[3]  J. Richter,et al.  ACG Practice Guidelines: Esophageal Reflux Testing , 2007, The American Journal of Gastroenterology.

[4]  J. Johansson,et al.  Wireless oesophageal pH monitoring: Feasibility, safety and normal values in healthy subjects , 2005, Scandinavian journal of gastroenterology.

[5]  J. Pandolfino,et al.  Ambulatory Esophageal pH Monitoring Using a Wireless System , 2003, American Journal of Gastroenterology.

[6]  H. Garewal,et al.  Non‐erosive reflux disease (NERD) — acid reflux and symptom patterns , 2003, Alimentary pharmacology & therapeutics.

[7]  D. Castell,et al.  Updated Guidelines for the Diagnosis and Treatment of Gastroesophageal Reflux Disease , 1999, The American Journal of Gastroenterology.

[8]  A. Csendes,et al.  Location of the lower oesophageal sphincter and the squamous columnar mucosal junction in 109 healthy controls and 778 patients with different degrees of endoscopic oesophagitis. , 1993, Gut.

[9]  J. Richter,et al.  Ambulatory 24-hour esophageal pH monitoring , 1988, Digestive Diseases and Sciences.

[10]  M. Numans,et al.  Short-term treatment with proton-pump inhibitors as a test for gastroesophageal reflux disease: a meta-analysis of diagnostic test characteristics. , 2004, Annals of internal medicine.