Wireless esophageal PH monitoring. Clinical evaluation of a new technique

Esophageal pH monitoring is important in the clinical management of patients with symptoms suggestive of gastroesophageal reflux disease (GERD), and in research aiming to clarify the mechanisms involved in the development of GERD complications. Catheter-based techniques for pH recording are uncomfortable, not well tolerated by all patients and cannot reliably measure acid exposure in the most distal esophagus the region most prone to reflux-induced complications. New wireless technique using a pH recording capsule attached to the esophageal mucosa was evaluated to provide a scientific basis for the clinical use of the technique, and to characterize acid exposure in the most distal esophagus. Healthy volunteers and symptomatic patients underwent wireless 48-h esophageal pH monitoring with endoscopic placement of pH recording capsules at the standard position 6 cm above the squamocolumnar junction (SCJ) and immediately above the SCJ. The patient's perceived experience of the wireless and catheter-based techniques were compared in a randomized cross-over trial. The wireless technique was feasible regarding capsule placement and recording of pH data via radiotelemetry, and there were no complications related to the procedure. Premature capsule detachment and signal interruption occurred but were uncommon at the standard electrode position. Endoscopic placement of the wireless capsule followed by 48-h pH recording was, compared to manometry and 24-h catheter-based monitoring, associated with less adverse symptoms, less interference with normal daily life and was preferred by a significant majority of symptomatic patients. Analysis of the diagnostic performance of the wireless pH test showed that the total percent time with esophageal pH