Evaluation of Esophageal Mucosal Integrity in Patients with Gastroesophageal Reflux Disease

Digestion. 2018;97(1):31-37. doi: 10.1159/000484106. Epub 2018 Feb 1.

Abstract

Background: Impaired esophageal mucosal integrity plays a role in causing symptoms of gastroesophageal reflux disease (GERD). Recently, the assessment of esophageal baseline impedance (BI) using the multichannel intraluminal impedance-pH (MII-pH) test was suggested as a surrogate technique for the study of esophageal mucosal integrity and was reported to be useful in distinguishing GERD from non-GERD. However, measuring BI requires a 24-h testing period, is complicated, and causes considerable patient discomfort.

Summary: Recently, endoscopy-guided catheters that can measure mucosal impedance (MI) and mucosal admittance (MA), which is the inverse of impedance, were developed, and their usefulness in measuring MI and MA for the diagnosis of GERD has been reported. In these studies, esophageal MI values were significantly lower in patients with GERD than in those without GERD. In contrast, esophageal MA was significantly higher in patients with GERD than in those without. Furthermore, we reported that MA is inversely correlated with BI and correlated with acid exposure time. Key Messages: Endoscopy-guided real-time measurement of MI and MA may allow the estimation of mucosal integrity and may be a useful diagnostic tool for patients with GERD in a manner similar to 24-h MII-pH monitoring.

Keywords: Baseline impedance; Functional heartburn; Gastroesophageal reflux disease; Mucosal admittance; Mucosal impedance; Nonerosive reflux disease; Proton pump inhibitor refractory gastroesophageal reflux disease.

Publication types

  • Evaluation Study
  • Review

MeSH terms

  • Catheters
  • Electric Impedance*
  • Esophageal Mucosa / diagnostic imaging*
  • Esophageal Mucosa / pathology
  • Esophageal pH Monitoring
  • Esophagoscopes
  • Esophagoscopy / instrumentation
  • Esophagoscopy / methods*
  • Gastroesophageal Reflux / diagnostic imaging*
  • Gastroesophageal Reflux / pathology
  • Humans
  • Hydrogen-Ion Concentration
  • Monitoring, Physiologic / adverse effects
  • Monitoring, Physiologic / methods
  • Time Factors