No abstract available.
Esophageal pH Monitoring* ; Gastroesophageal Reflux*

The purpose of this study was to determine aluminium (Al) concentrations in groundwater used for drinking and cooking and its related health risk among population of 28th Mile Orang Asli village in Jenderam Hilir, Selangor, Malaysia. A total of 100 respondents were recruited, comprising 51 (51.0 %) male and 49 (49.0 %) female residents. Inductively coupled plasma mass spectrometry (ICP-MS) was used to determine Al concentration, while the LAMOTTE TRACER ORP PockeTester was used to measure pH levels. Statistical Package for Social Science (SPSS) was used to analyze the data. Results showed that Al concentration ranged from 0.041 - 0.136 mg/L with a mean of 0.136 + SD 0.041 mg/L, hence the values obtained were below the standard value (0.2 mg/L). pH levels ranged from 3.82 to 5.84, with a mean of 4.163 + SD 0.411, which is acidic and below the range permitted by the health authorities. The acidic nature may have an impact on the Al concentration in the water. The Hazard Index (HI) was found to be less than 1, thus there was no health risk of Al exposure in drinking water for the respondents involved. The study area was considered safe from having health risk associated with Al exposure.
Aluminium ; Ph ; drinking water ; groundwater ; Hazard Index

BACKGROUND/AIMS: Impedance-pH monitoring allows detailed characterization of gastroesophageal reflux and esophageal activity associated with reflux. We assessed the characteristics of nocturnal reflux and esophageal activity preceding and following reflux. METHODS: Impedance-pH tracings from 11 healthy subjects and 76 patients with gastroesophageal reflux disease off acid-suppressive therapy were analyzed. Characteristics of nocturnal supine reflux, time distribution and esophageal activity seen on impedance at 2 minute intervals preceding and following reflux were described. RESULTS: Patients had more nocturnal reflux events than healthy subjects (8 [4-12] vs 2 [1-5], P = 0.002), with lower proportion of weakly acidic reflux (57% [35-78] vs 80% [60-100], P = 0.044). Nocturnal reflux was mainly liquid (80%) and reached the proximal esophagus more often in patients (6% vs 0%, P = 0.047). Acid reflux predominated in the first 2 hours (66%) and weakly acidic reflux in the last 3 hours (70%) of the night. Most nocturnal reflux was preceded by aboral flows and cleared by short lasting volume clearance. In patients, prolonged chemical clearance was associated with less esophageal activity. CONCLUSIONS: Nocturnal weakly acidic reflux is as common as acid reflux in patients with gastroesophageal reflux disease, and predominates later in the night. Impedance-pH can predict prolonged chemical clearance after nocturnal acid reflux.
Electric Impedance ; Esophageal pH Monitoring ; Esophagus ; Gastroesophageal Reflux ; Humans

PURPOSE: The aim of this study was to determine clinical significance of dual-probe esophageal pH monitoring and to compare four pH monitoring parameters between proximal and distal esophagus in pathological gastroesophageal reflux disease with recurrent respiratory symptoms. METHODS: Among the thirty-four patients who were performed 24 hr pH monitoring, seventeen patients with pathological distal reflux were classified into two groups: Group I (n:12) had recurrent respiratory symptoms and Group II (n:5) hadn't recurrent respiratory symptoms. The ambulatory dual-probe esophageal pH monitoring was performed for 18~24 hr. A pathologic GER was defined when reflux index (percent of the investigation time a pH<4) exceeded the 95th percentile of normal value. RESULTS: Among the sixteen patients with recurrent respiratory symptoms, twelve patients (75%) have pathological distal reflux. Whereas among the eighteen patients without recurrent respiratory symptom, five patients (28%) have pathological distal reflux. In the Group I, the significant differences between proximal and distal esophageal pH recordings persisted for all parameters, but didn't persist in group II except for longest episode. Comparing esophageal pH four parameters between group I and group II at the proximal esophageal site, all parameters didn't show statistically significant differences. CONCLUSION: Regardless of respiratory symptoms, patients with pathological distal reflux didn't show statistically significant differences in the all parameters at the proximal esophageal site. Therefore we may reconsider usefulness of dual probe pH meter in patients with recurrent respiratory symptoms.
Esophageal pH Monitoring* ; Esophagus ; Gastroesophageal Reflux* ; Humans ; Hydrogen-Ion Concentration ; Reference Values

BACKGROUND/AIMS: Several specific foods are known to precipitate gastroesophageal reflux disease (GERD) symptoms and GERD patients are usually advised to avoid such foods. However, foods consumed daily are quite variable according to regions, cultures, etc. This study was done to elucidate the food items which induce typical GERD symptoms in Korean patients. METHODS: One hundred and twenty-six Korean patients with weekly typical GERD symptoms were asked to mark all food items that induced typical GERD symptoms from a list containing 152 typical foods consumed daily in Korea. All patients underwent upper gastrointestinal endoscopy followed by 24-hour ambulatory esophageal pH monitoring. The definition of “GERD” was if either of the 2 studies revealed evidence of GERD, and “possible GERD” if both studies were negative. RESULTS: One hundred and twenty-six cases (51 GERD and 75 possible GERD) were enrolled. In 19 (37.3%) of 51 GERD cases and in 17 (22.7%) of 75 possible GERD cases, foods inducing typical GERD symptoms were identified. In the GERD group (n = 19), frequent symptom-inducers were hot spicy stews, rice cakes, ramen noodles, fried foods, and topokki. In the possible GERD group (n = 17), frequent symptom-inducers were hot spicy stews, fried foods, doughnuts, breads, ramen noodles, coffee, pizza, topokki, rice cakes, champon noodles, and hotdogs. CONCLUSIONS: In one-third of GERD patients, foods inducing typical symptoms were identified. Hot spicy stews, rice cakes, ramen noodles, fried foods, and topokki were the foods frequently inducing typical symptoms in Korea. The list of foods frequently inducing typical GERD symptoms needs to be modified based on their own local experiences.
Bread ; Coffee ; Endoscopy, Gastrointestinal ; Esophageal pH Monitoring ; Gastroesophageal Reflux* ; Humans ; Korea* ; Symptom Assessment

Esophageal pH monitoring is considered the gold standard for the diagnosis of gastroesophageal reflux disease because of the normal ranges across the pediatric age range. However, this method can only detect acid reflux. Multichannel intraluminal impedance-pH (MII-pH) monitoring has recently been used for the detection of bolus reflux in infants and children. This method allows for the detection of liquid, gas or mixed reflux in addition to acid, weakly acidic or weakly alkaline reflux. MII-pH monitoring can record the direction of flow and the height of reflux, which are useful parameters to identify an association between symptoms and reflux. However, the technique is limited by its high cost and the lack of normative data of MII-pH in the pediatric population. Despite certain limitations, MII-pH monitoring will become more common and gradually replace pH monitoring in the future, because pH monitoring is part of MII-pH.
Child* ; Diagnosis ; Esophageal pH Monitoring ; Gastroesophageal Reflux ; Humans ; Hydrogen-Ion Concentration* ; Infant ; Reference Values

Newer developing techniques for esophageal functional testing such as wireless pH capsule monitoring and esophageal impedance testing are currently available. However, ambulatory 24 hr esophageal pH monitoring is still widely used and provides quantitative data on esophageal acid exposure and the ability to correlate symptoms with acid exposure events. To properly analyze the result of pH monitoring, it is recommended to interpret in the order presented: visual inspection, computer calculation and symptom correlation.
Electric Impedance ; Esophageal pH Monitoring ; Gastroesophageal Reflux ; Hydrogen-Ion Concentration ; Reference Values

BACKGROUND/AIMS: Available data about reflux patterns and symptom determinants in the gastroesophageal reflux disease (GERD) subtypes off proton pump inhibitor (PPI) therapy are lacking. We aimed to evaluate reflux patterns and determinants of symptom perception in patients with GERD off PPI therapy by impedance-pH monitoring. METHODS: We retrospectively reviewed the impedance-pH data in patients diagnosed as GERD based on results of impedance-pH monitoring, endoscopy and/or typical symptoms. The characteristics of acid and weakly acidic reflux were evaluated. Symptomatic and asymptomatic reflux were compared according to GERD subtypes and individual symptoms. RESULTS: Forty-two patients (22 males, mean age 46 years) were diagnosed as GERD (17 erosive reflux disease, 9 pH(+) non-erosive reflux disease [NERD], 9 hypersensitive esophagus and 7 symptomatic NERD). A total of 1,725 reflux episodes were detected (855 acid [50%], 857 weakly acidic [50%] and 13 weakly alkaline reflux [< 1%]). Acid reflux was more frequently symptomatic and bolus clearance was longer compared with weakly acidic reflux. In terms of globus, weakly acidic reflux was more symptomatic. Symptomatic reflux was more frequently acid and mixed reflux; these associations were more pronounced in erosive reflux disease and symptomatic NERD. The perception of regurgitation was related to acid reflux, while that of globus was more related to weakly acidic reflux. CONCLUSIONS: In patients not taking PPI, acid reflux was more frequently symptomatic and had longer bolus clearance. Symptomatic reflux was more frequently acid and mixed type; however, weakly acidic reflux was associated more with globus. These data suggest a role for impedance-pH data in the evaluation of globus.
Electric Impedance ; Endoscopy ; Esophageal pH Monitoring ; Esophagus ; Gastroesophageal Reflux ; Humans ; Male ; Proton Pumps ; Protons ; Retrospective Studies

The exact incidence of esophagitis in gastroesophageal reflux disease (GERD) remains poorly understood in Korea. To determine incidence of esophagitis in GERD, from August 1988 to July 1993, endoscopy, esophageal manometry with Bernstein test, and ambulatory 24 hour esophageal pH monitoring were carried out in a group of 349 patients with symptoms of heartburn or noncardiac chest pain. Based on these studies, 151(40%) patients had some degree of GERD and pstients were categorized as having: pathologic reflux, 98 patients; symptomatic reflux, 42 patients; and sensitive mucosal reflux, 11 patients. Among 151 patients with GERD, 27 patients(18%) had some degree of esophagitis. In conclusion, 40% of patients with symptoms suggestive of GERD have GERD. GERD is divided into subgroups; pathologic reflux, symptomatic reflux, and mucosal sensitive reflux. Less than 20% of GERD have esophagitis or esophageal mucosal injury and these low incidence of mucosal injury in Korean may be due to increased esophageal mucosal resistance.
Chest Pain ; Endoscopy ; Esophageal pH Monitoring ; Esophagitis* ; Esophagitis, Peptic ; Gastroesophageal Reflux* ; Heartburn ; Humans ; Incidence* ; Korea ; Manometry

PURPOSE: The aim of this study was to evaluate the significance of pH monitoring at two levels, hypopharynx and esophagus in gastroesophageal reflux. METHODS: 29 patients with pathological gastroesophageal reflux were classified into two groups: Group I had recurrent respiratory symptoms and Group II had not recurrent respiratory symptoms. The ambulatory pH monitoring was performed at the hypopharynx and the esophagus simultaneously with two channel catheter for 18~24 hr. The pathological reflux was defined when the percent of time that pH was below 4.0 exceeding the 95th percentile of normal value. Hypopharyngeal reflux was defined as the pharyngeal pH drops below 4. RESULTS: 39 patients were performed pH monitoring at the level of hypopharynx and esophagus for 24 hours. Among 7 patients with chronic respiratory symptom, 6 patients (85.7%) have pathological esophageal reflux. Among 32 patients without chronic respiratory symptom, 23 patients (71.8%) have pathological esophageal reflux. Thus 29 out of 39 patients (74%) have pathological esophageal reflux. In the Group I, all parameters except the longest episode showed significant differences between hypopharyngeal and esophageal pH monitoring. None of parameters showed significant differences between group I and II in the pharyngeal pH monitoring. CONCLUSION: Regardless of presence of respiratory symptoms, the pH monitoring at the pharyngeal level in patients with gastroesophageal reflux did not showed any differences compared with the esophageal pH monitoring. Therefore we may reconsider the usefulness of hypopharyngeal pH monitoring in patients with chronic respiratory symptoms.
Catheters ; Esophageal pH Monitoring ; Esophagus ; Gastroesophageal Reflux* ; Humans ; Hydrogen-Ion Concentration* ; Hypopharynx ; Reference Values