ArticleThe American journal of gastroenterology2014
Acid-based parameters on pH-impedance testing predict symptom improvement with medical management better than impedance parameters.
Article in The American journal of gastroenterology, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 34 papers, 1 of them a synthesis that pooled it.
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Who cites it
34 citing papers in PubMed, 1 synthesis or guideline pooled it, 65 citations in OpenAlex.
- ACG Clinical Guidelines: Clinical Use of Esophageal Physiologic Testing.The American journal of gastroenterology · 2020Guideline
- Outcomes of endoscopic submucosal dissection for gastroesophageal reflux disease (ESD-G) for medication-refractory gastroesophageal reflux disease: 35 cases underwent ESD-G including 15 cases followed more than 5 years.BMC gastroenterology · 2021Trial
- [Clinical Significance of the Mean Nocturnal Baseline Impedance and Post-Reflux Swallow-Induced Peristaltic Wave Index in the Diagnosis of Gastroesophageal Reflux Disease].The Korean journal of gastroenterology = Taehan Sohwagi Hakhoe chi · 2025Review
- Validation of Esophageal Global Symptom Severity as a Patient-Reported Outcome for Evaluation of Reflux Symptoms.The American journal of gastroenterology · 2025Article
- Latin American consensus on diagnosis of gastroesophageal reflux disease.Neurogastroenterology and motility · 2024Article
- Clinical use of mean nocturnal baseline impedance and post-reflux swallow-induced peristaltic wave index for the diagnosis of gastro-esophageal reflux disease.Esophagus : official journal of the Japan Esophageal Society · 2022Review
- The Lyon Consensus Criteria for GERD Diagnosis in a Greek Population: The Clinical Impact and Changes in GERD Diagnosis in a Real-World, Retrospective Study.Journal of clinical medicine · 2022Article
- Diagnosis and Management of Refractory Gastroesophageal Reflux Disease.Gastroenterology & hepatology · 2021Article
- Non-acid Reflux: What to Do When You Don't Feel the Burn.Digestive diseases and sciences · 2021Article
- Can acid exposure time replace the DeMeester score in the diagnosis of gastroesophageal reflux-induced cough?Therapeutic advances in chronic disease · 2021Article
- Value of adjunctive evidence from MII-pH monitoring and high-resolution manometry in inconclusive GERD patients with AET 4-6.Therapeutic advances in gastroenterology · 2021Article
- High-resolution Manometry Determinants of Refractoriness of Reflux Symptoms to Proton Pump Inhibitor Therapy.Journal of neurogastroenterology and motility · 2020Article
- Esophageal Baseline Impedance From High-resolution Impedance Manometry Correlates With Mean Nocturnal Baseline Impedance From pH-impedance Monitoring.Journal of neurogastroenterology and motility · 2020Article
- Optimization of impedance-measured reflux events in GORD utilizing acid exposure time.BMC gastroenterology · 2020Article
- Wireless 24, 48, and 96 Hour or Impedance or Oropharyngeal Prolonged pH Monitoring: Which Test, When, and Why for GERD?Current gastroenterology reports · 2018Review
- Chronic Cough Is Associated With Long Breaks in Esophageal Peristaltic Integrity on High-resolution Manometry.Journal of neurogastroenterology and motility · 2018Article
- Review
- Genetic risk factors for perception of symptoms in GERD: an observational cohort study.Alimentary pharmacology & therapeutics · 2018Observational
- Expert consensus document: Advances in the physiological assessment and diagnosis of GERD.Nature reviews. Gastroenterology & hepatology · 2017Review
- Combined pH-impedance testing for reflux: current state of play and future challenges.Frontline gastroenterology · 2017Article
Corrections and comments
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Authors and funding
3 authors at 1 institution in 1 country.
Funding
Abstract
objectivespH-impedance testing detects reflux events irrespective of pH, but its value in predicting treatment outcome is unclear. We prospectively evaluated subjects treated medically after pH-impedance testing to determine predictors of symptom improvement.
methodsSubjects referred for pH-impedance testing completed questionnaires in which dominant symptoms and global symptom severity (GSS) were recorded. Acid-reflux parameters (acid-exposure time, AET; symptom association by Ghillebert probability estimate, GPE; symptom index, SI) and impedance reflux parameters (reflux-exposure time, RET; number of reflux events; GPE and SI with impedance data) were extracted. Symptoms and GSS were prospectively reevaluated after medical therapy. Univariate and multivariate analyses determined predictors of GSS improvement following medical management.
resultsOver 5 years, 128 subjects (mean 53.3±1.3 years, 66.4% female; typical symptoms 57.0%, 53.9% tested on therapy) underwent pH-impedance testing and subsequent medical therapy for reflux symptoms, and completed required questionnaires. On follow-up 3.35±0.14 years later, mean GSS declined by 45.0%, with 42.2% patients reporting ≥50% GSS improvement. On univariate analysis, total AET, AET≥4.0%, and GPE for all reflux events predicted both linear and ≥50% GSS improvement, but RET and number of reflux events did not. On multivariate analysis, controlling for testing on or off therapy, only AET (P=0.003) and GPE for all reflux events (P=0.029) predicted GSS improvement.
conclusionsAcid-based reflux parameters offer greater value over impedance-based nonacid-reflux parameters in predicting symptomatic responses to proton pump inhibitor (PPI) therapy. Our findings support conducting pH-impedance studies off PPI therapy to maximize clinical utility in predicting outcome.
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