PMID- 21844921
OWN - NLM
STAT- MEDLINE
DCOM- 20120216
LR  - 20220317
IS  - 1572-0241 (Electronic)
IS  - 0002-9270 (Linking)
VI  - 106
IP  - 12
DP  - 2011 Dec
TI  - Esophageal acid exposure decreases intraluminal baseline impedance levels.
PG  - 2093-7
LID - 10.1038/ajg.2011.276 [doi]
AB  - OBJECTIVES: Intraluminal baseline impedance levels are determined by the 
      conductivity of the esophageal wall and can be decreased in gastroesophageal 
      reflux disease (GERD) patients. The aim of this study was to investigate the 
      baseline impedance in GERD patients, on and off proton pump inhibitor (PPI), and 
      in healthy controls. METHODS: Ambulatory 24-h pH-impedance monitoring was 
      performed in (i) 24 GERD patients with and 24 without pathological esophageal 
      acid exposure as well as in 10 healthy controls and in (ii) 20 patients with 
      refractory GERD symptoms despite PPI, once on PPI and once off PPI. Baseline 
      impedance levels in the most distal and the most proximal impedance channels were 
      assessed. RESULTS: Median (interquartile range) distal baseline impedance in 
      patients with physiological (2,090 (1,537-2,547) Omega) and pathological (781 
      (612-1,137) Omega) acid exposure was lower than in controls (2,827 (2,127-3,270) Omega, 
      P<0.05 and P<0.001). A negative correlation between 24-h acid exposure time and 
      baseline impedance was observed (r=-0.7, P<0.001). In patients measured off and 
      on PPI, median distal baseline impedance off PPI was significantly lower than on 
      PPI (886 (716-1,354) vs. 1,372 (961-1,955) Omega, P<0.05) and distal baseline 
      impedance in these groups was significantly lower than in healthy controls 
      (P<0.05 and P<0.001). Proximal baseline impedance did not differ significantly 
      between the patients off PPI and on PPI (1,793 (1,384-2,489) vs. 1,893 
      (1,610-2,561) Omega); however, baseline impedance values in both measurements were 
      significantly lower than in healthy controls (3,648 (2,815-3,932) Omega, both 
      P<0.001). CONCLUSIONS: These findings suggest that baseline impedance is related 
      to esophageal acid exposure and could be a marker of reflux-induced changes to 
      the esophageal mucosa.
FAU - Kessing, Boudewijn F
AU  - Kessing BF
AD  - Department of Gastroenterology and Hepatology, Academic Medical Center Amsterdam, 
      The Netherlands. b.f.kessing@amc.uva.nl
FAU - Bredenoord, Albert J
AU  - Bredenoord AJ
FAU - Weijenborg, Pim W
AU  - Weijenborg PW
FAU - Hemmink, Gerrit J M
AU  - Hemmink GJ
FAU - Loots, Clara M
AU  - Loots CM
FAU - Smout, A J P M
AU  - Smout AJ
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20110816
PL  - United States
TA  - Am J Gastroenterol
JT  - The American journal of gastroenterology
JID - 0421030
RN  - 0 (Proton Pump Inhibitors)
SB  - IM
CIN - Am J Gastroenterol. 2012 Jul;107(7):1104; author reply 1104-5. PMID: 22764027
MH  - Adult
MH  - Aged
MH  - Case-Control Studies
MH  - Drug Resistance
MH  - Electric Conductivity
MH  - Electric Impedance
MH  - *Esophageal pH Monitoring
MH  - Esophagus/*metabolism
MH  - Female
MH  - Gastric Acid/*metabolism
MH  - Gastroesophageal Reflux/*metabolism
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Proton Pump Inhibitors/*therapeutic use
MH  - Young Adult
EDAT- 2011/08/17 06:00
MHDA- 2012/02/18 06:00
CRDT- 2011/08/17 06:00
PHST- 2011/08/17 06:00 [entrez]
PHST- 2011/08/17 06:00 [pubmed]
PHST- 2012/02/18 06:00 [medline]
AID - ajg2011276 [pii]
AID - 10.1038/ajg.2011.276 [doi]
PST - ppublish
SO  - Am J Gastroenterol. 2011 Dec;106(12):2093-7. doi: 10.1038/ajg.2011.276. Epub 2011 
      Aug 16.