Four-day Bravo pH capsule monitoring with and without proton pump inhibitor therapy.pdf

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Four-day Bravo pH capsule monitoring with and without proton pump inhibitor therapy.pdf

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Four-day Bravo pH capsule monitoring with and without proton pump inhibitor therapy

F P I D B u d a s c a f w P 4 c w o w p a a P i t a 3 u c P p u g A d a p g d s g b f i d CLINICAL GASTROENTEROLOGY AND HEPATOLOGY 2005;3:1083–1088our-Day Bravo pH Capsule Monitoring With and Without roton Pump Inhibitor Therapy KUO HIRANO, QING ZHANG, JOHN E. PANDOLFINO, and PETER J. KAHRILAS ivision of Gastroenterology, Northwestern University Feinberg School of Medicine, Chicago, Illinois ( t l c r o i p S p m p i e w t 4 c p t n w p t t c n w t p dackground Aims: Ambulatory pH testing often is sed to guide the management of reflux symptoms that o not respond to proton pump inhibitor (PPI) therapy nd to evaluate the contribution of acid reflux to atypical ymptoms. Controversy exists as to whether such clini- al studies are performed optimally off or on PPI ther- py. The aim of the present study was to determine the easibility of 4-day pH recordings using a pH system that ould encompass time periods both before and during PI therapy. Methods: Eighteen patients underwent -day ambulatory pH testing using 2 separate receivers alibrated to a single Bravo pH capsule. Rabeprazole as administered on days 2–4 of the study (20 mg rally twice a day). Results: Indications for pH testing ere refractory heartburn, chest pain, or chronic cough. H recordings showed that 9 patients (53%) had esoph- geal acid exposure values that exceeded 4% on day 1 nd 7 patients (41%) had values that exceeded 5.3%. atients showed significant and progressive reductions n acid exposure on days 2–4 of the recording period. Of he 7 patients with quantitatively abnormal levels of cid exposure on day 1, 86% had normalization by day . Conclusions: Prolonged, esophageal pH recordings sing the Bravo pH system are feasible and allow for ombined testing both off and on a therapeutic trial of PI. Such studies may allow for the acquisition of com- lementary information in a single test that may be seful in the management of patients with suspected astroesophageal reflux disease symptoms. mbulatory pH testin