title: Reflux patterns in patients with short-segment Barrett's oesophagus: a study using impedance-pH monitoring off and on proton pump inhibitor therapy.
abstract: BACKGROUND
  In short-segment Barrett's oesophagus (SSBO) heartburn may be absent and oesophageal acid exposure time (OAET) assessed with pH-only monitoring may be normal. By detecting reflux episodes independently of their acidity, multichannel intraluminal impedance-pH (MII-pH) monitoring allows a comprehensive characterization of reflux events, either off or on proton pump inhibitor (PPI) therapy.
  
  
  OBJECTIVE
  To assess reflux parameters by MII-pH monitoring in newly diagnosed SSBO, at baseline and as modified with PPI therapy.
  
  
  METHODS
  Short-segment Barrett's oesophagus was defined by oesophageal intestinal metaplasia up to 3 cm in length. 24-h MII-pH monitoring was performed before and during PPI therapy.
  
  
  RESULTS
  Fifty patients were studied prospectively. Normal OAET was found at baseline in 15 patients (30%), 8 and 2 of whom with a higher than normal number of acid and weakly acidic refluxes, respectively. Overall, abnormal reflux parameters were detected by MII-pH monitoring in 90% of patients. Reflux events were prevalent in the upright period. On PPI therapy, acid refluxes decreased and a correspondent increase in weakly acidic refluxes was observed (median from 48.5 to 9 and from 16 to 57.5, respectively) (P < 0.001).
  
  
  CONCLUSIONS
  Acid refluxes, mainly in the upright period, characterize SSBO. PPI therapy transforms acid refluxes into weakly acidic refluxes.
authors.affiliation: Gastroenterologia - Nuovo Ospedale S. Agostino, Modena, Italy. m.frazzoni@ausl.mo.it
authors.forename: M
authors.initials: M
authors.lastname: Frazzoni
authors.forename: E
authors.initials: E
authors.lastname: Savarino
authors.forename: M
authors.initials: M
authors.lastname: Manno
authors.forename: G
authors.initials: G
authors.lastname: Melotti
authors.forename: V G
authors.initials: VG
authors.lastname: Mirante
authors.forename: A
authors.initials: A
authors.lastname: Mussetto
authors.forename: H
authors.initials: H
authors.lastname: Bertani
authors.forename: R
authors.initials: R
authors.lastname: Manta
authors.forename: R
authors.initials: R
authors.lastname: Conigliaro
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000897:Anti-Ulcer Agents / Q000627:therapeutic use*; D001471:Barrett Esophagus / Q000188:drug therapy* / Q000503:physiopathology; D050782:Esophageal pH Monitoring; D005260:Female; D005764:Gastroesophageal Reflux / Q000188:drug therapy* / Q000503:physiopathology; D006356:Heartburn; D006801:Humans; D006863:Hydrogen-Ion Concentration; D008297:Male; D008365:Manometry; D008875:Middle Aged; D011446:Prospective Studies; D054328:Proton Pump Inhibitors / Q000627:therapeutic use*; D055815:Young Adult
chemical_list: D000897:Anti-Ulcer Agents; D054328:Proton Pump Inhibitors