ArticleClinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association2015
Parameters on esophageal pH-impedance monitoring that predict outcomes of patients with gastroesophageal reflux disease.
Article in Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 84 papers, 4 of them syntheses that pooled it.
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Who cites it
84 citing papers in PubMed, 4 syntheses or guidelines pooled it, 189 citations in OpenAlex.
- Efficacy of gut-brain neuromodulators in functional esophageal disorders: a systematic review.BMC gastroenterology · 2026Pooled it
- Association between body mass index at different levels and risk of gastroesophageal reflux disease: a systematic review with dose-response meta-analysis.Frontiers in physiology · 2025Pooled it
- ACG Clinical Guidelines: Clinical Use of Esophageal Physiologic Testing.The American journal of gastroenterology · 2020Guideline
- Guideline
- Novel physiologic nomogram discriminates symptom outcome in patients with erosive esophagitis.Esophagus : official journal of the Japan Esophageal Society · 2021Trial
- Gastroesophageal Reflux Disease and Reflux-like Phenotypes: Using Lyon Consensus 2.0 to Guide Clinical Approach.Journal of neurogastroenterology and motility · 2026Review
- Obstructive Sleep Apnea and Gastroesophageal Reflux Disease: A Systematic Review and Meta-Analysis of Observational Studies.Journal of clinical medicine · 2026Review
- The Efficacy of Potassium-Competitive Acid Blocker Compared With Double Dose of Proton Pump Inhibitor in Patients With Refractory Gastro-Esophageal Reflux Disease: A Case-Control Study.The Korean journal of helicobacter and upper gastrointestinal research · 2025Article
- Combined Lyon and Milan Scores Predict Gerd Management Outcome Better Than Either Score Alone or Their Individual Components.Alimentary pharmacology & therapeutics · 2025Article
- Demographic and Manometric Variables Can Independently Predict Gastroesophageal Reflux Disease: The AGES-D Score.The Korean journal of helicobacter and upper gastrointestinal research · 2025Article
- Validation of Esophageal Global Symptom Severity as a Patient-Reported Outcome for Evaluation of Reflux Symptoms.The American journal of gastroenterology · 2025Article
- Response to Vittori et al.The American journal of gastroenterology · 2025Article
- Management of Patients With Refractory Reflux-Like Symptoms Despite Proton Pump Inhibitor Therapy: Evidence-Based Consensus Statements.Alimentary pharmacology & therapeutics · 2025Article
- Diagnosis and Management of Gastroesophageal Reflux Disease: Current Insights.Clinical and experimental gastroenterology · 2025Review
- Transoral Incisionless Fundoplication Leads to Esophageal Mucosa Healing in Responder Patients Followed up to 2 Years, as Documented by Esophageal Mean Nocturnal Baseline Impedance.Journal of neurogastroenterology and motility · 2024Article
- Latin American consensus on diagnosis of gastroesophageal reflux disease.Neurogastroenterology and motility · 2024Article
- Higher obesity class is associated with more severe esophageal symptoms and reflux burden but not altered motor function or contractile reserve.Neurogastroenterology and motility · 2024Article
- Executing and facilitating the successful combined multichannel intraluminal impedance and pH monitoring study.Translational gastroenterology and hepatology · 2024Review
- The Utility of Symptom Association Probability (SAP) in Predicting Outcome After Laparoscopic Fundoplication in Patients with Abnormal Esophageal Acid Exposure.Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · 2023Article
- The role of magnetic sphincter augmentation in the gastroesophageal reflux disease treatment pathway: the gastroenterology perspective.Diseases of the esophagus : official journal of the International Society for Diseases of the Esophagus · 2023Article
24 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
3 authors at 1 institution in 1 country.
Funding
Abstract
BACKGROUND &
aimspH-impedance monitoring detects acid and nonacid reflux events, but little is known about which parameters predict outcomes of different management strategies. We evaluated a cohort of medically and surgically managed patients after pH-impedance monitoring to identify factors that predict symptom improvement after therapy.
methodsIn a prospective study, we followed up 187 subjects undergoing pH-impedance testing from January 2005 through August 2010 at Washington University in St. Louis, Missouri (mean age, 53.8 ± 0.9 y; 70.6% female). Symptom questionnaires assessed dominant symptom intensity (DSI) and global symptom severity (GSS) at baseline and at follow-up evaluation. Data collected from pH impedance studies included acid exposure time (AET), reflux exposure time (RET) (duration of impedance decrease 5 cm above lower esophageal sphincter, reported as the percentage of time similar to AET), symptom reflux correlation (symptom index and symptom association probability [SAP]), and the total number of reflux events. Univariate and multivariate analyses were performed to determine factors associated with changes in DSI and GSS after therapy.
resultsOf the study subjects, 49.7% were tested on proton pump inhibitor (PPI) therapy and 68.4% were managed medically. After 39.9 ± 1.3 months of follow-up, DSI and GSS scores decreased significantly (P < .05). On univariate analysis, an abnormal AET predicted decreased DSI and GSS scores (P ≤ .049 for each comparison); RET and SAP from impedance-detected reflux events (P ≤ .03) also were predictive. On multivariate analysis, abnormal AET consistently predicted symptomatic outcome; other predictors included impedance-detected SAP, older age, and testing performed off PPI therapy. Abnormal RET, acid symptom index, or SAP, and numbers of reflux events did not independently predict a decrease in DSI or GSS scores.
conclusionsPerforming pH-impedance monitoring off PPI therapy best predicts response to antireflux therapy. Key parameters with predictive value include increased AET, and correlation between symptoms and reflux events detected by impedance.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.