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Endoscopy 2012; 44(03): 270-276
DOI: 10.1055/s-0031-1291541
Review
© Georg Thieme Verlag KG Stuttgart · New York

Wireless pH capsule – yield in clinical practice

S. Roman
1   Digestive Physiology, Hospices Civils de Lyon, Edouard Herriot Hospital, Lyon; Université Claude Bernard Lyon 1, Lyon, France
,
F. Mion
1   Digestive Physiology, Hospices Civils de Lyon, Edouard Herriot Hospital, Lyon; Université Claude Bernard Lyon 1, Lyon, France
,
F. Zerbib
2   Department of Gastroenterology and Hepatology, CHU Bordeaux, Saint André Hospital, Bordeaux ; Université Victor Segalen Bordeaux 2, Bordeaux, France
,
R. Benamouzig
3   Gastroenterology Department, Assistance Publique – Hôpitaux de Paris, Avicenne Hospital, Bobigny; Université Paris 13, Bobigny, France
,
J. C. Letard
4   Polyclinique de Poitiers, Poitiers, France
,
S. Bruley des Varannes
5   CHU Nantes, Institut des Maladies de l’Appareil Digestif, CIC-INSERM, Nantes; Université de Nantes, Nantes, France
› Author Affiliations
Further Information

Publication History

submitted 13 March 2011

accepted after revision 14 October 2011

Publication Date:
24 January 2012 (online)

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Wireless pH monitoring is one of the recent technologies that focus on improving the diagnosis of gastroesophageal reflux disease (GERD). The capsule, which is fixed within the esophagus, transmits data via telemetry to an external receiver. The capsule is usually inserted 6 cm above the squamocolumnar junction during an upper endoscopy. The standard recording duration is 48 hours but this can be extended to 96 hours. The wireless capsule has been shown to be at least as accurate as the conventional catheter for the monitoring of esophageal pH. Normal pH values have been established in three different series. The use of a wireless capsule provides an increased diagnostic yield for GERD compared with the conventional catheter. The increased yield is the result of higher sensitivity to detect both abnormal acid esophageal exposure and positive symptom – reflux association. This may be related both to the prolonged recording duration and to fewer dietary modifications and restrictions on activities. Several studies have shown that the pH capsule was better tolerated by patients than the conventional pH catheter. Mild-to-moderate chest pain represents the main side effect of the pH capsule: severe chest pain requiring endoscopic removal of the capsule is rare. The main indication for wireless capsule application is monitoring of distal esophageal pH for diagnostic purpose, particularly in patients with a normal endoscopic examination. The capsule technique has some limitations: costs are higher than conventional pH monitoring, misplacement may occur, and the sampling rate is lower. Finally, compared with pH-impedance monitoring, only acid reflux events can be evaluated.

 

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