06 Ingestion of Acidic不要最后一页.pdf

Digestive Diseases and Sciences, Vol. 50, No. 10 (October 2005), pp. 1916–1920 ( C 2005) DOI: 10.1007/s10620-005-2961-6 Ingestion of Acidic Foods Mimics Gastroesophageal Reflux During pH Monitoring AMIT AGRAWAL, MD, RADU TUTUIAN, MD, AMINE HILA, MD, JANICE FREEMAN, RN, and DONALD O. CASTELL, MD Ingestion of acidic foods may produce artifactual drops in pH to 4 that may be difficult to dif- ferentiate from a true acid reflux event. We aimed to evaluate intraesophageal pH changes during the ingestion of acidic food and describe the frequency and implications of acidic food ingestion on ambulatory pH monitoring. Ten normal volunteers (six females; mean age, 34) underwent combined impedance–pH testing with a pH electrode placed 5 cm above the lower esophageal sphincter. Each volunteer received 50 ml each of acidic foods in random order. Nadir and mean pH for 30 sec after in- gestion of each substance were recorded. Subsequently 100 randomly selected reflux monitor diaries were reviewed, searching for ingestion of acidic foods, and 100 pH tracings were reviewed to evaluate the impact of including/excluding meal periods on percentage time pH 4 and DeMeester scores. All foods produced abrupt drops to pH 4, in 80% of cases exceeding 30 sec. During ambulatory pH monitoring 78% of patients recorded ingestion of at least 1 of the 10 tested substances during meals, the majority admitting ingesting carbonated beverages. Not excluding meal periods would have led to the misinterpretation of 6–16% of tracings, depending on the criteria used to identify abnormal acid exposure. We conclude that ingestion of acidic foods is frequent and carries the risk of