title: Prolonged 2-day esophageal pH-metry with impedance monitoring improves symptom-reflux association analysis.
abstract: BACKGROUND
  The day-to-day variability in the number of reflux episodes and symptoms of gastro-esophageal reflux disease is high; therefore, the assessment of reflux disease based on 24-h monitoring may be inaccurate.
  
  
  OBJECTIVE
  The aim of the study was to compare prolonged (48 h) and standard (24 h) pH-impedance monitoring (pH-MII).
  
  
  METHODS
  Fifty-four consecutive patients with typical and atypical reflux symptoms underwent 48-h pH-MII. Acid exposure time (AET), total number of reflux episodes (TR), number of symptoms, and symptom association probability (SAP) were analyzed after the first 24 h and compared with the results obtained during 48 h of monitoring.
  
  
  RESULTS
  The differences between the fractions of patients with normal and abnormal total AET and TR on both days were not significant. The percentage of patients with positive SAP was 57.9% at 24 h and 71.9% at 48 h (difference: 14.81%, 95% CI 0.7-21.29, P<0.05). There were ten patients (10/54, 18.5%) with positive SAP after 48 h that had been negative in the first 24 h. In comparison to 24 h monitoring, patients reported a significantly increased number of various symptoms correlated with reflux after 48 h.
  
  
  CONCLUSIONS
  Extending pH-MII monitoring to 48 h does not improve the detection of abnormal acid exposure. However, it does increase the fraction of patients with positive symptom-reflux association by as much as 18.5%.
authors.affiliation: Department of Gastroenterology and Internal Medicine, Medical University of Bialystok, ul. M. Curie-Sklodowskiej 24a, 15-276, Bialystok, Poland. agnkatswidnicka@op.pl
authors.forename: Agnieszka
authors.initials: A
authors.lastname: Swidnicka-Siergiejko
authors.forename: Andrzej
authors.initials: A
authors.lastname: Dabrowski
mesh_terms: D000328:Adult; D000368:Aged; D017097:Electric Impedance; D050782:Esophageal pH Monitoring; D005260:Female; D005764:Gastroesophageal Reflux / Q000175:diagnosis* / Q000188:drug therapy / Q000453:epidemiology / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D011044:Poland / Q000453:epidemiology; D054328:Proton Pump Inhibitors / Q000627:therapeutic use; D012189:Retrospective Studies; D055815:Young Adult
chemical_list: D054328:Proton Pump Inhibitors