Comparison of the Wireless (Bravo) pH Monitoring Device Monitoring Parameters with the Traditional 24 hr pH Monitoring in the Evaluation of Gastroesophageal Reflux Disease

Abstract

Purpose: Before the development of the wireless pH monitoring device (capsule), the evaluation of patients with presumed GERD was performed by a 24 hr intranasal inserted pH probe. The traditional 24 hr dual channel probe is capable of directly evaluating the pH in the esophagus. This function has also been demonstrated equally with the use of a wireless device called as ‘Bravo capsule’ which is endoscopically inserted into the esophagus. The tolerability of this procedure and validity of the pH recordings has been already studied and was found to be valid. DeMeester (DM) score is an index used by clinicians to determine the degree of severity of GERD both on traditional 24 hr pH monitoring, as well as wireless pH monitoring. To evaluate the usefulness of the DM score as a reflection of severity of GERD in both techniques, this study was undertaken to retrospectively analyze the pH monitoring parameters in both 24 hr dual channel pH and wireless capsule pH studies, in patients with clinical manifestations of GERD. Methods: In this study we evaluated the pH monitoring parameters such as number of refluxes, number of long refluxes, the duration of longest reflux, period of time with pH < 4 and fraction of the time of pH < 4, which are used as variables in the compilation of the DM score. These variables were analyzed and compared with the parameters of the pH monitoring readings, who had wireless pH monitoring technique. Results: The statistical analysis, showed that the wireless pH monitoring group had a stronger correlation of DM score with the parameters like the number of total refluxes (0.79), total time of pH < 4 (0.88) and total fraction time of pH < 4 (0.93) and was found significant when compared with the traditional 24 hr pH monitoring group, which showed a correlation with the number of total refluxes (0.58), total time of pH < 4 (0.86) and total fraction time of pH < 4 (0.87). Conclusions: There is stronger correlation of the DM score with the individual parameters in the pH recording by wireless technique when compared with the traditional 24 hr method.Table: DeMeester Score and its Parameters