[Catheter-free pH-metry using the Bravo capsule versus standard pH-metry in patients with non-erosive reflux disease (NERD)].
BACKGROUND
pH-monitoring is considered the gold standard for the detection of acid reflux in patients with non-erosive reflux disease (NERD). Preliminary pH studies performed over periods longer than 24 hours have shown that in up to one-third of subjects abnormal pH exposure is detected only on the second day of monitoring. Therefore, pH-monitoring during 48 hours may yield more information about pathological acid reflux in patients being investigated for NERD.


OBJECTIVE
The aim of this study was to compare conventional 24-hour pH-monitoring with the new wireless 48-hour Bravo pH-monitoring in patients with NERD.


METHODS
Patients with typical reflux symptoms, a positive reflux disease questionnaire and negative endoscopy (NERD) and without any form of acid suppressive therapy were included in this prospective study. The patients were divided into two groups: group A for conventional 24-hour pH-monitoring and group B for wireless 48-h Bravo pH-monitoring.


RESULTS
76 patients with a diagnosis of NERD based on a positive RDQ questionnaire and negative endoscopy were included. (47 woman, 29 men, median age: 49 years). 54 underwent conventional pH-monitoring and 22 underwent 48-h pH-monitoring with the new wireless BRAVO system. The overall incidence of acid reflux was 55 % in patients with NERD. Acid reflux was detected less frequently when using Bravo as compared to conventional pH-monitoring. In addition, the Bravo pH-metry showed a large day-to-day variability.


CONCLUSIONS
Prolonged pH-monitoring over a period longer than 24 hours did not improve the detection of acid reflux in patients with NERD. Thus, it appears that the Bravo pH-metry does not offer an advantage over standard pH-metry in the daily clinical practice.
Mönkemüller
K
K
Gastroenterologie, Hepatologie und Infektiologie, Uniklinikum Magdeburg, Leipzigerstr. 44, 39120 Magdeburg. klaus.moenkemueller@medizin.uni-magdeburg.de
Neumann
H
H
Fry
L C
LC
Kolfenbach
S
S
Malfertheiner
P
P
D000293:Adolescent; D000328:Adult; D000368:Aged; D004867:Equipment Design; D050782:Esophageal pH Monitoring / Q000295:instrumentation*; D005260:Female; D005764:Gastroesophageal Reflux / Q000175:diagnosis*; D005773:Gastroscopy; D006801:Humans; D007441:Intubation, Gastrointestinal / Q000295:instrumentation; D008297:Male; D008875:Middle Aged; D008904:Miniaturization; D018670:Monitoring, Ambulatory / Q000295:instrumentation*; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D012815:Signal Processing, Computer-Assisted / Q000295:instrumentation*; D012984:Software; D055815:Young Adult