title: Gastroesophageal reflux evaluation in patients affected by chronic cough: Restech versus multichannel intraluminal impedance/pH metry.
abstract: OBJECTIVE
  Oropharyngeal (OP) pH monitoring has been developed to detect supra-esophageal gastric reflux (SEGR). The results obtained with OP pH-metry and multichannel intraluminal impedance/pH monitoring (MII/pH) were compared.
  
  
  METHODS
  Diagnostic study.
  
  
  METHODS
  Ten patients (age 46.33 ± 9.86 years) presenting with chronic coughing underwent simultaneous OP and MII/pH recording. A 2-minute interval was allowed between events detected with both techniques to be considered simultaneous.
  
  
  RESULTS
  A total of 515 reflux episodes were recorded with MII/pH (acid: 181; weakly acid: 310; weakly alkaline: 24); 180 (35%) reached the highest impedance channel (hypo-pharynx); 74/180 (41%) were not related to a change in pH, according to the antimony electrode of the MII/pH catheter located at the upper esophageal sphincter. The OP monitoring measured 39 acid events; 17 (43.6%) were swallows according to MII, and 15 (38.5%) were not associated with MII or pH change. Only seven episodes were detected simultaneously with both techniques (1.3% for MII vs. 18% for OP; P = 0.0002). We found 49 pH-only refluxes at the pH sensor in the hypo-pharynx with MII/pH; only three (6.1%) correlated with OP reflux. Correlation in time between cough and reflux events was positive in 5/10 patients for MII (symptom index 5/10, symptom association probability 4/10), but in 0/10 patients according to OP pH metry.
  
  
  CONCLUSIONS
  OP pH metry detected less reflux episodes than MII/pH; 35% of the OP events were swallows according to impedance. Time correlation between cough and reflux could not be demonstrated with OP pH metry.
authors.affiliation: Department of Pediatrics, UZ Brussel, Brussels, Belgium.
authors.forename: Dario
authors.initials: D
authors.lastname: Ummarino
authors.forename: Liv
authors.initials: L
authors.lastname: Vandermeulen
authors.forename: Bart
authors.initials: B
authors.lastname: Roosens
authors.forename: Daniel
authors.initials: D
authors.lastname: Urbain
authors.forename: Bruno
authors.initials: B
authors.lastname: Hauser
authors.forename: Yvan
authors.initials: Y
authors.lastname: Vandenplas
mesh_terms: D000328:Adult; D000368:Aged; D002908:Chronic Disease; D003371:Cough / Q000150:complications*; D017097:Electric Impedance; D050782:Esophageal pH Monitoring / Q000295:instrumentation*; D005764:Gastroesophageal Reflux / Q000150:complications / Q000175:diagnosis*; D006801:Humans; D006863:Hydrogen-Ion Concentration; D008875:Middle Aged