Brief Article
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World J Gastroenterol. Mar 21, 2013; 19(11): 1805-1810
Published online Mar 21, 2013. doi: 10.3748/wjg.v19.i11.1805
Esophagogastroduodenoscopy with conscious sedation does not interfere with catheter-based 24-h pH monitoring
Yung-Kuan Tsou, Jau-Min Lien, Chin-Kuo Chen, Cheng-Hui Lin, Hsing-Yu Chen, Mu-Shien Lee
Yung-Kuan Tsou, Jau-Min Lien, Cheng-Hui Lin, Mu-Shien Lee, Department of Gastroenterology and Hepatology, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taoyuan 333, Taiwan
Chin-Kuo Chen, Department of Otolaryngology, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taoyuan 333, Taiwan
Hsing-Yu Chen, Center for Traditional Chinese Medicine, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taoyuan 333, Taiwan
Author contributions: Tsou YK conceptualized and designed the study, performed 24-h pH monitoring, analyzed and interpreted the data, and wrote the manuscript; Lien JM revised the manuscript and gave final approval of the version to be published; Chen CK, Lin CH, and Lee MS collected data; Chen HY performed the statistical analyses.
Supported by A Grant from Chang Gung Memorial Hospital, CMRPG300011
Correspondence to: Yung-Kuan Tsou, MD, Department of Gastroenterology and Hepatology, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, 5, Fu-Shin Street, Kweishan, Taoyuan 333, Taiwan. flying3454@xuite.net
Telephone: +886-3-3281200 Fax: +886-3-3272236
Received: October 25, 2012
Revised: December 17, 2012
Accepted: December 25, 2012
Published online: March 21, 2013
Processing time: 148 Days and 13.4 Hours
Abstract

AIM: To investigate the impact of esophagogastroduodenoscopy with conscious sedation on the subsequent 24-h catheter-based pH monitoring.

METHODS: Fifty patients with extra-esophageal symptoms of gastroesophageal reflux disease undergoing ambulatory dual-probe 24-h pH monitoring were enrolled from March 2010 to August 2011. All of the data were collected prospectively and analyzed retrospectively. Thirty-six patients (72%, group A) underwent pH monitoring shortly after esophagogastroduodenoscopy (EGD) with conscious sedation, and 14 patients (28%, group B) underwent pH monitoring without conscious sedation. The 24-h pH data from two time periods were analyzed: the first 4 h (Period I) and the remaining time of the study (Period II).

RESULTS: The mean age of the patients was 49.6 ± 12.5 years; 20 patients (40%) were men. The baseline data, including age, sex, body mass index, reflux esophagitis, the Reflux Symptom Index, and the Reflux Findings Score, were comparable between the two groups. The percentage of total time with a pH < 4 and the frequency of acid reflux during Period I were not significantly different between the two groups, as measured using both pharyngeal (0.03% ± 0.10% vs 0.07% ± 0.16%, P = 0.32; and 0.07 ± 0.23 episodes/h vs 0.18 ± 0.47 episodes/h, P = 0.33, respectively) and esophageal probes (0.96% ± 1.89% vs 0.42% ± 0.81%, P = 0.59; and 0.74 ± 1.51 episodes/h vs 0.63 ± 0.97 episodes/h, P = 0.49, respectively). The percentage of total time with a pH < 4 and the frequency of acid reflux were also not significantly different between Periods I and II in group A patients, as measured using both pharyngeal (0.03% ± 0.10% vs 0.23% ± 0.85%, P = 0.21; and 0.07 ± 0.23 episodes/h vs 0.29 ± 0.98 episodes/h, P = 0.22, respectively) and esophageal probes (0.96% ± 1.89% vs 1.11% ± 2.57%, P = 0.55; and 0.74 ± 1.51 episodes/h vs 0.81 ± 1.76 episodes/h, P = 0.55, respectively).

CONCLUSION: EGD with conscious sedation does not interfere with the results of subsequent 24-h pH monitoring in patients with extra-esophageal symptoms of gastroesophageal reflux disease.

Keywords: Esophagogastroduodenoscopy; Conscious sedation; pH monitoring; Gastroesophageal reflux disease; Extraesophageal symptoms