PTU-140 The Effect of Proton Pump Inhibitors (PPIS) on Oesophageal Acid Reflux using a Prolonged Wire-Less Bravo PH Monitoring
Notice bibliographique
Résumé
Introduction Recently prolonged catheter-free pH monitoring (Bravo ® , Given Imaging, Yoqeam, Israel) up to 96 hours has become possible which enables more physiological evaluation of oesophageal acid exposure and its response to therapeutic interventions. This study applied this technology to measure acid reflux, and reflux related symptoms in patients with proven gastro-oesophageal reflux disease on and off high-dose PPIs. The potential utility of this methodology in guiding medical therapy was assessed. Methods Patients with reflux symptoms were recruited prospectively from Mar.2012 to Oct.2012. PPI was stopped for 7 days prior to the Bravo capsule insertion. The 1st 48hr pH recording was performed off PPI and the 2nd 48hr was on twice daily PPI. The 48hr pH and symptom data for the two periods were compared, including percentages of acid exposure in total, upright and supine periods and symptom–reflux association for which heartburn (HB), chest pain (CP) and regurgitation (RG) were analysed. Data were expressed as median & interquartile. Wilcoxon signed-rank and Mann Whitney tests were used for statistical analysis (*P < 0.05; **P < 0.01; *** < 0.001). Results Data from prolonged pH monitoring up to 96 hours were available from 89patients of whom 36 (22 males, mean age 50, range 26–76 years old) with complete studies and pathological acid exposure in the 1st 48 hours were studied in detail. Acid reflux measurements on PPI therapy were greatly reduced when compared to those recorded off therapy (Table). 27/36 (75%) patients had normal acid exposure on PPI therapy. The overall number of HB and CP reported in the 2nd 48hr period was reduced by almost two thirds (13 (4–26) vs.5 (2–14)**); however the number of these symptoms that were actually associated with acid reflux events was almost completely abolished (4 (2–14) vs.1 (0–3)***). No effect on volume RG was present. Abstract PTU-140 Table The effects of PPI on oesophageal acid reflux and symptoms (Off PPI/On PPI) Fraction time pH < 4(%): Total 10.45(7.2–15.5)/1.9 (0.6–4.9) *** Upright 9.4(6.1–15.6)/2.5(0.9–5.3)*** Supine 9.7(5.0–16.1)/0.1(0–2.2)*** No. of reflux events associated with symptoms: HB 8(2–15)/1(0–3)*** RG 2(1–8)/1(0–3)(P = 0.0975) CP 3(2–6)/1(0–3)* Conclusion Sequential 48hrs recording off/on PPI therapy using Bravo pH test is feasible in routine clinical practise. This technique documents the physiological and clinical response to PPI therapy on acid reflux and acid reflux associated symptoms (i.e. heartburn, chest pain). These preliminary findings suggest that this methodology could be of value in distinguishing symptoms related to acid reflux that respond to acid suppression and guiding medical therapy in reflux disease. Disclosure of Interest None Declared
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».