Sa1165 - Qualitative Evaluation of the Composition of Refluxate by 24-Hour Multichannel Esophageal Intraluminal Impedance and pH-Monitoring and its Relationship to Extraesophageal Reflux Disease

Abstract

We presented a study focused on qualitative evaluation of the composition of refluxate and its relationship with extraesophageal symptoms. Gastroesophageal reflux disease (GERD) is a disease caused by backflow of gastric contents into the esophagus due to the failure of physiological antireflux mechanisms and can lead to esophageal and extraesophageal symptomatology. Extraesophageal reflux (EER) is a condition where refluxate penetrate above the upper esophageal sphincter (UES) in to the oral cavity, pharynx, upper and lower respiratory tract and leads to pathological changes. The examinations in our study were carried out using 24-hour multichannel intraluminal impedance and pH esophageal monitoring (MII-pH), which compared to the more commonly used conventional pH-monitoring can accurately detect reflux episodes at all pH levels and divide the episodes to acid reflux, weakly acidic reflux and nonacid reflux, and also provides information of the composition of refluxate (liquid, gas and mixture). We evaluated results of the examinations from 200 patients in two groups. The first group included 100 patients with classic GERD and in the second group were 100 patients with EER symptoms. We evaluated DeMeester score, the number of reflux episodes by pH, simultaneously the state of matter and the rate of penetration in the UES area. Patients with EER symptoms have more weakly acid reflux episodes and fewer acid reflux episodes compared to a group of patients with classical GERD symptoms while we found minor differences in the frequency of individual components of refluxate. In the group with EER we also observed lower values of DeMeester score, a higher number of gaseous reflux episodes and generally significantly higher number of penetration of refluxate of all states of matter to the UES area.