caa a22 4500 445796758 CHVBK 20180317145128.0 cr unu---uuuuu 170323e20110501xx s 000 0 eng 10.1007/s10620-010-1443-7 doi (NATIONALLICENCE)springer-10.1007/s10620-010-1443-7 The Effect of Antisecretory Therapy and Study Duration on Ambulatory Esophageal pH Monitoring [Elektronische Daten] [Vladimir Kushnir, Gregory Sayuk, C. Gyawali] Background: Conventional catheter-based and wireless pH monitoring continue to be widely used for the evaluation of GERD symptoms despite the emergence of pH-impedance monitoring. Goals: We sought to identify patient- and test-related factors predicting objective GERD parameters on catheter-based and wireless pH monitoring. Study: Ambulatory pH studies in 2,067 subjects (50.4±0.3years, 66.3% female) were assessed for presenting symptoms, antireflux therapy status, test characteristics, distal esophageal total acid exposure time (AET), symptom index (SI), and symptom-reflux association (Ghillebert probability estimate, GPE). Univariate and multivariate logistic regression analyses were performed to identify predictors of GERD evidence, both off and on antireflux therapy. Results: Catheter-based pH monitoring was performed in 77.6%, and 90.1% of the studies were performed off antireflux therapy. The likelihood of finding GERD evidence was significantly higher off therapy (65.8 vs. 21.4% on therapy, p<0.0001); this held true for both strong GERD evidence (elevated AET and positive GPE) and elevated AET alone. The SI did not complement AET and GPE. Extended pH recording with the wireless technique consistently increased diagnostic yield. On multivariate logistic regression, the status of antireflux therapy and frequency of symptoms dictated finding of GERD evidence, and yields were highest for perceptive symptoms (heartburn, chest pain, and cough). Conclusions: Ambulatory pH testing off antireflux therapy improves detection of all degrees of GERD evidence. pH testing provides highest yields with frequent perceptive symptoms and least with isolated regurgitation and ENT symptoms. Extending pH-recording with wireless monitoring uniformly augments yield. Springer Science+Business Media, LLC, 2010 pH monitoring nationallicence Catheter-based monitoring nationallicence GERD symptoms nationallicence Antireflux therapy nationallicence Kushnir Vladimir Division of Gastroenterology, Washington University School of Medicine, 660 S. Euclid Ave, Campus Box 8124, 63110, St. Louis, MO, USA aut Sayuk Gregory Division of Gastroenterology, Washington University School of Medicine, 660 S. Euclid Ave, Campus Box 8124, 63110, St. Louis, MO, USA aut Gyawali C. Division of Gastroenterology, Washington University School of Medicine, 660 S. Euclid Ave, Campus Box 8124, 63110, St. Louis, MO, USA aut Digestive Diseases and Sciences Springer US; http://www.springer-ny.com 56/5(2011-05-01), 1412-1419 0163-2116 56:5<1412 2011 56 10620 https://doi.org/10.1007/s10620-010-1443-7 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s10620-010-1443-7 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Kushnir Vladimir Division of Gastroenterology, Washington University School of Medicine, 660 S. Euclid Ave, Campus Box 8124, 63110, St. Louis, MO, USA aut NATIONALLICENCE 700 1- Sayuk Gregory Division of Gastroenterology, Washington University School of Medicine, 660 S. Euclid Ave, Campus Box 8124, 63110, St. Louis, MO, USA aut NATIONALLICENCE 700 1- Gyawali C. Division of Gastroenterology, Washington University School of Medicine, 660 S. Euclid Ave, Campus Box 8124, 63110, St. Louis, MO, USA aut NATIONALLICENCE 773 0- Digestive Diseases and Sciences Springer US; http://www.springer-ny.com 56/5(2011-05-01), 1412-1419 0163-2116 56:5<1412 2011 56 10620 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer