The Yield of Combined Multichannel Intraluminal Impedance and pH Monitoring (MII-pH Monitoring) among Suspected Refractory Gastroesophageal Reflux Disease: A St. Luke’s Medical Center Experience
Keywords:
retrospective, cross-sectional, MII-pH monitoring, refractory GERAbstract
Background:
Multichannel intraluminal impedance and pH monitoring (MII-pH monitoring) allows accurate recording of gastroesophageal reflux at all pH levels. In the Philippines, there is no local data on the yield of these tests in the investigation of patients with refractory gastroesophageal reflux disease (GERD).
Objective:
The objective of this study is to determine the phenotypic presentation and diagnostic yield of MII-pH monitoring among Filipino patients with suspected refractory GERD.
Methodology:
This is a retrospective, cross-sectional study involving suspected refractory GERD patients who underwent MII-pH monitoring.
Results:
A total of 50 subjects were included. Most presented with typical symptoms of reflux, such as heartburn (44%) and regurgitation (40%). Most common study indication was refractoriness to proton pump inhibitors (PPI) (86%). Patients under phenotypic group of persistent acid reflux (abnormal acid exposure with positive symptom association) revealed prevalence of 20%. Majority were males, with esophagitis, and normal esophageal motor function. Patients under the phenotypic group of hypersensitive esophagus (normal acid exposure with positive symptom association), revealed a prevalence of 18%. Patients were mostly female who presented without esophagitis, 56% with normal manometric findings. Patients under the group of functional heartburn (normal acid exposure with negative symptom association) revealed prevalence of 62%. Majority were female, with normal manometric findings and without esophagitis.
Conclusion:
Among refractory GERD patients, functional heartburn was the most common diagnosis using MII-pH monitoring, showing higher prevalence compared to previous studies. MII-pH monitoring is helpful in the work-up of refractory GERD patients as it can redirect the course of management.
