Acid Reflux: New Technology To Use To Diagnose Complicated Reflux Disorders
Ohio State University physicians are putting new technology to use to diagnose complicated reflux disorders that don’t respond to anti-acid medications.
Though many gastroesophageal reflux disease cases can be controlled by drugs that suppress acid, some reflux sufferers find no relief from over-the-counter or prescription medicines because acid isn’t a factor in their disorder. But before this technology became available for clinical uses, such cases were difficult to diagnose.
The gold standard for detecting acid reflux is pH monitoring, a test that measures how often and for how long stomach acid enters the esophagus. This monitoring can now be combined with the use of impedance technology, which uses electrical currents to sense the movement of stomach contents upward into the esophagus.
“For a long time, we have been able to tell if acid reflux occurred because we could detect the acid,” said Dr. David Quinn, a gastroenterologist at The Ohio State University Medical Center. “This new technology can detect whether the reflux is acidic or non-acidic with minimal inconvenience to the patient.”
Patients wear the catheter for 24 hours, and also carry a paging device electronically connected to the catheter’s sensors. When patients experience heartburn and other symptoms, they press a button on the device, which also collects impedance data when reflux actually does occur.
“Because this is an ambulatory test, patients can carry out normal activities, and we actually want them to go about their daily routine so they will have their usual symptoms,” said Quinn, medical director of endoscopy in OSU’s division of digestive diseases.
The next day, information from the pager is fed into a computer, and physicians can look for a correlation between the presence of symptoms and whether reflux occurred at the same time.
“This way, we are able to detect non-acidic reflux and whether it occurs with typical or atypical symptoms,” he said. “In the past, we were only able to detect pH levels. Now, we can detect when the material is actually moving and see what’s going on in the bottom of the esophagus.”
“Antacids don’t work for these patients with non-acidic reflux. And even though they don’t have inflammation or pain associated with acid, they still have bothersome symptoms that affect their quality of life.”
Typical reflux symptoms are heartburn, an acidic taste in the mouth, chest discomfort, a sensation that food is stuck after being swallowed and chest pain. Atypical reflux symptoms include asthma, laryngitis and chronic cough.
Patients with symptomatic non-acidic reflux disease typically are candidates for a laparoscopic surgical procedure in which the upper part of the stomach is wrapped around the bottom of the esophagus. Doctors also can determine if endoscopic reflux therapies, generally designed to tighten or thicken the junction of the esophagus and stomach, could help patients with symptomatic non-acidic reflux.
The Sleuth Impedance-pH Monitoring System technology used at OSU Medical Center was developed by Sandhill Scientific, based in Highlands Ranch, Colo.
Emily Caldwell - COLUMBUS, Ohio
Medical Center Communications 614.293.3737 - http://www.medicalcenter.osu.edu/