The evolving role of the wireless pH capsule in evaluation of patients with GERD

Abstract

Ambulatory pH testing can be a valuable diagnostic modality for patients in whom the diagnosis of gastroesophageal reflux disease is uncertain. The utility of conventional catheter-based pH systems has been limited, albeit modestly, by patient discomfort, leading to deviation from dietary and activity limitation during the 24-hour monitoring period. The advent of wireless capsule pH monitoring is a significant advance that enhances both the diagnosis and management of reflux disease. The capsule system has improved the tolerability and acceptance of pH testing by patients. By extending recording periods beyond 24 hours, wireless pH monitoring increases the sensitivity for the diagnosis of reflux and allows incorporation of periods both off-proton pump inhibitor (PPI) and on-PPI testing in a single study. Furthermore, a 48-to 96-hour recording window increases the detection of symptom events that may be temporally associated with reflux episodes using symptom association analyses.