Bravo (wireless) ambulatory esophageal pH monitoring: how do day 1 and day 2 results compare?
OBJECTIVE
To investigate if differences exist for patients' gastroesophageal reflux as measured by the Bravo ambulatory esophageal pH system between d 1 and d 2.


METHODS
A retrospective study of 27 consecutive adult patients who underwent Bravo esophageal pH monitoring was performed. Patients underwent EGD under IV conscious sedation prior to Bravo placement. Acid reflux variables and symptom scores for d 1 were compared to d 2.


RESULTS
The mean doses of fentanyl and midazolam were 90.4 microg and 7.2 mg, respectively. D 1 results were significantly more elevated than d 2 with respect to total time pH < 4, upright position reflux, and mean number of long refluxes. No statistical difference was noted between the two days for supine position reflux, number of refluxes, duration of longest reflux, episodes of heartburn, and symptom score.


CONCLUSIONS
Patients undergoing Bravo esophageal pH monitoring in association with EGD and moderate conscious sedation experience significantly more acid reflux on d 1 compared to d 2. The IV sedation may be responsible for the increased reflux on d 1. Performed this way, 48-h Bravo results may not be entirely representative of the patients' true GE reflux profile.
Bechtold
Matthew L
ML
Division of Gastroenterology University of Missouri School of Medicine, One Hospital Drive, Columbia, MO 65212, USA.
Holly
Jason-Scott L
JS
Thaler
Klaus
K
Marshall
John B
JB
D000293:Adolescent; D000328:Adult; D000368:Aged; D016292:Procedural Sedation / Q000009:adverse effects; D050782:Esophageal pH Monitoring / Q000295:instrumentation*; D004947:Esophagus / Q000502:physiology*; D005260:Female; D005764:Gastroesophageal Reflux / Q000175:diagnosis / Q000503:physiopathology*; D006801:Humans; D006863:Hydrogen-Ion Concentration; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013997:Time Factors
Dig Dis Sci. 1999 Nov;44(11):2263-9
10573372
Am J Gastroenterol. 2003 Apr;98(4):740-9
12738450
Am J Gastroenterol. 2005 Jan;100(1):8-10
15654773
Aliment Pharmacol Ther. 2005 Jan 15;21(2):155-63
15679765
Clin Gastroenterol Hepatol. 2005 Apr;3(4):329-34
15822037
Gut. 2005 Dec;54(12):1682-6
15843417
Gastrointest Endosc. 2005 Oct;62(4):485-7
16185957
J Gastrointest Surg. 2005 Nov;9(8):1043-51; discussion 1051-2
16269374
Clin Gastroenterol Hepatol. 2005 Nov;3(11):1083-8
16271338
Am J Gastroenterol. 2005 Nov;100(11):2382-6
16279888
Gut. 2005 Dec;54(12):1672-3
16284282
J Clin Gastroenterol. 2006 Jan;40(1):20-4
16340628
J Clin Gastroenterol. 2006 Feb;40(2):116-21
16394871
Am J Gastroenterol. 2007 Feb;102(2):239-45
17100971
Gastroenterol Hepatol (N Y). 2006 Nov;2(11):835-842
28381954
Gastroenterology. 1996 Jun;110(6):1982-96
8964428