Esophageal Mucosal Admittance: A New Technique to Diagnose Gastroesophageal Reflux Disease - Is It Feasible?

Hang Viet Dao; Long Bao Hoang; Binh Phuc Nguyen; Hoa Lan Nguyen; Robert Goldberg; Jeroan Allison; Thi Minh An Dao; Tomoaki Matsumura; Long Van Dao

doi:10.2147/CEG.S399764

Esophageal Mucosal Admittance: A New Technique to Diagnose Gastroesophageal Reflux Disease - Is It Feasible?

Clin Exp Gastroenterol. 2023 Apr 7:16:45-54. doi: 10.2147/CEG.S399764. eCollection 2023.

Authors

Hang Viet Dao^{1

2

3}, Long Bao Hoang³, Binh Phuc Nguyen³, Hoa Lan Nguyen⁴, Robert Goldberg⁴, Jeroan Allison⁴, Thi Minh An Dao^{5

6}, Tomoaki Matsumura⁷, Long Van Dao^{1

3}

Affiliations

¹ Internal Medicine Faculty, Hanoi Medical University, Hanoi, Vietnam.
² Endoscopy Center, Hanoi Medical University Hospital, Hanoi, Vietnam.
³ Institute of Gastroenterology and Hepatology, Hanoi, Vietnam.
⁴ Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA, USA.
⁵ School of Public Health, University of Queensland, Brisbane, Australia.
⁶ Epidemiology Department, Hanoi Medical University, Hanoi, Vietnam.
⁷ Department of Gastroenterology, Graduate School of Medicine, Chiba University, Chiba, Japan.

Abstract

Purpose: Esophageal mucosal admittance (MA) is a promising diagnostic method for gastroesophageal reflux disease (GERD). We conducted a study to describe the esophageal MA in patients with reflux symptoms and determine its diagnostic accuracy.

Patients and methods: We recruited 92 patients with ambulatory pH-impedance monitoring, upper gastrointestinal endoscopy, and MA measured by the tissue conductance meter. MA was measured during endoscopy at 5cm (distal esophagus) and 15cm above the Z line (middle esophagus), repeated at least five times at each position, and median MA was obtained. Afterwards, two biopsies were taken 5cm above the Z line for histopathological evaluation using the Esohisto criteria. Patients were classified as GERD or non-GERD according to the 2018 Lyon consensus.

Results: The mean age was 43.2 years, and 42 patients were males. The most common symptoms were regurgitation (75.0%), belching (65.2%), and heartburn (46.7%). Twenty-three (32.3%) were diagnosed with GERD using the Lyon consensus, and 24 (26.1%) had esophagitis on histopathology. The median MA at the distal and middle esophagus was moderately correlated. The median MA at both positions was higher in the GERD group but only statistically significant in the middle esophagus. MA was not associated with pH-impedance parameters and esophagitis on histopathology. The diagnostic model developed using the logistic regression did not have good accuracy.

Conclusion: MA was not different between GERD and non-GERD patients.

Keywords: Lyon consensus; mucosal permeability; pH-impedance monitoring; tissue conductance meter.

Grants and funding

This study was part of the national project “Evaluation of motility and secretion disorders in some upper gastrointestinal diseases” (No. 1846, approved on 27 June 2019) funded by Vietnam’s Ministry of Science and Technology and was also supported by the Fogarty International Center of the US National Institutes of Health under award number D43 TW011394-01.