Positioning of the pH-probe by manometry or radiography for monitoring of the esophagus. Influence on diagnostic results?
OBJECTIVE
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.


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.


CONCLUSIONS
In 146 patients submitted to 24-h pH monitoring, the pH-probe could be placed as safely by radiography as by manometry.
Aksglaede
K
K
Motility Laboratory, Department of Radiology R, Aarhus University Hospital, Aarhus, Denmark. kbaks@akh.aaa.dk
Thommesen
P
P
D001466:Barium Sulfate; D003287:Contrast Media; D004943:Esophagogastric Junction / Q000000981:diagnostic imaging; D004947:Esophagus / Q000378:metabolism*; D005260:Female; D005764:Gastroesophageal Reflux / Q000175:diagnosis* / Q000000981:diagnostic imaging; D006801:Humans; D006863:Hydrogen-Ion Concentration; D008297:Male; D008365:Manometry; D008875:Middle Aged; D008991:Monitoring, Physiologic / Q000295:instrumentation / Q000379:methods*; D011859:Radiography; D012680:Sensitivity and Specificity
D003287:Contrast Media; D001466:Barium Sulfate