EoE ToT Module 4 References-Ates et al Gastroenterology 2015 Mucosal impedance discriminates GERD from non Gerd conditions

Ates et al Gastroenterology 2015 Mucosal impedance discriminates GERD from non Gerd conditions

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The study investigates the efficacy of a minimally invasive device designed to measure esophageal mucosal impedance (MI) as a diagnostic marker for gastroesophageal reflux disease (GERD). Patients with various conditions, including GERD, eosinophilic esophagitis (EoE), achalasia, and a control group without GERD, were assessed using this device. MI measurements were taken at multiple points within the esophagus before and after treatment with proton pump inhibitors and compared with results from traditional wireless pH monitoring.<br /><br />Key findings include:<br />- MI values were significantly lower in patients with GERD and EoE compared to those without GERD or with achalasia.<br />- MI patterns were distinct in GERD patients, displaying lower impedance closer to the gastroesophageal junction that normalized with treatment, unlike in EoE patients where MI values were uniformly low along the esophagus.<br />- MI measurements after PPI therapy showed significant increases, indicating recovery of mucosal impedance with effective treatment.<br />- Comparisons with wireless pH testing indicated that MI offered superior specificity (95%) and positive predictive values (96%) for detecting GERD, although sensitivity and negative predictive values were comparable.<br /><br />The MI-based approach addresses limitations of current GERD diagnostic methods, which often yield false negatives due to their reliance on short-duration reflux monitoring. The study highlights the potential of MI measurements to provide a consistent and reliable indication of chronic esophageal exposure to reflux, reducing the need for prolonged invasive pH testing.<br /><br />Additionally, the study underscores that MI can differentiate between GERD and EoE based on unique esophageal mucosal patterns, offering a promising diagnostic tool for a range of esophageal disorders. Despite some design constraints, such as the need for more refined sensors and radial measurements, the device shows promise in advancing GERD diagnostics and potentially improving patient management by directly assessing mucosal integrity. Future enhancements and validations are anticipated to improve sensitivity and overall diagnostic accuracy.

Keywords

esophageal mucosal impedance

minimally invasive device

GERD

eosinophilic esophagitis

achalasia

proton pump inhibitors

wireless pH monitoring

diagnostic marker

mucosal integrity

chronic esophageal exposure