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ESOPHAGEAL 24H PH-METRY AND MULTICHANNEL\ud INTRALUMINAL IMPEDANCE IN OBESE PATIENTS WITHOUT GERD\ud SYMPTOMS

By G. Ricci, C. Amella, S. Dari, A. Rossi, G. Bersani, A. Guida, A. Maimone and V. Alvisi

Abstract

INTRODUCTION: Twenty-four hours pH-metry and multichannel intraluminal\ud impedance monitoring (24h pH-metry+MII) allows the simultaneous assessment of\ud the chemical and physical properties of the gastroesophageal reflux.\ud AIMS & METHODS: To investigate 24h pH-metry+MII in obese and severely obese\ud patients without GERD symptoms and in controls. A total of 30 patients (13M/17F,\ud age 22−69 y, BMI 26–51.6 kg/m2) were admitted consecutively to the study, under\ud informed consent. Our patients were off PPI therapy. 24h pH-metry+MII monitoring\ud was carried out by recording system (Sandhill Scientific, Inc. Co, USA). Electrodes\ud at 3, 5, 7, 9, 15 and 17 cm above LES. Ten normal weight subjects with normal\ud 24-h pH-metry+MII were used as control group. The values were recorded as median\ud (25th, 25th) 95th percentile. Statistical analysis was performed with PASW 18.0 (SPSS,\ud Chicago, IL, USA).\ud RESULTS: The table shows the 24h pH-metry+MII data (MACT= Mean Acid\ud Clearance Time; MBCT= Mean Bolus Clearance Time) and reflux episodes in obese\ud patients and in controls. Ten obese patients showed grade A-C erosive esophagitis (LA\ud classification).\ud CONCLUSION: Obese patients showed an increased number of refluxes with acid\ud content. Acid reflux episodes with proximal extent, as well as Upright and Recumbent\ud weakly acidic episodes were significantly higher than controls. Despite abnormal 24h\ud pH-metry+MII indices, GERD symptoms were not observed in our obese patients.\ud As previously observed, these finding may be related to an altered visceral perception\ud which may also explain the abnormalities in the gastric accommodation and in the\ud sensation of fullness (1).\ud REFERENCE(S): [1] K¨uper MA, Kramer KM, Kischniak A, et al. Dysfunction of\ud lower esophageal sphincter and dismotility of the tubular esophagus in morbidly obese\ud patients. Obes Surg. 2009; 19: 1143

Year: 2012
OAI identifier: oai:iris.unife.it:11392/1725317
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