WIRELESS ESOPHAGEAL PH MONITORING FOR THE EVALUATION OF GASTROESOPHAGEAL REFLUX. INITAL EXPERIENCE

Aims:

Wireless esophageal pH monitoring (Bravo® system) consists of a small capsule endoscopically placed into the esophageal lumen which measures pH and transmits the data to an external receiver, without the need for a nasal probe and allowing a more than 24 hours recording.

Our aim is to evaluate the clinical (indication, feasibility and efficacy), endoscopic (technical data, safety and tolerance) aspects and the level of satisfaction of patients undergoing wireless esophageal pH monitoring.

Methods:

A descriptive retrospective 2 years review of the patients who underwent wireless esophageal pH monitoring for evaluation of GER.

Results:

82 patients (56 women) included.

Indications:

typical GER symptoms 34%; atypical GER symptoms: pulmonary 8%, ear, nose and throat 58%.

Technical indications:

Patient preference 72; intolerance to the probe 2; mixed study (24h without and 24h with proton pump inhibitors (PPIs) 4; clinical persistence of GER despite negative conventional pH monitoring 4.

Complications:

1 major (1.2%): intraoperative bleeding (sclerosing, impossibility to place the capsule); 7 minors (8.6%): 1 capsule not deployed, 3 capsules not attached and 3 patients with chest pain/transient dysphagia.

Results:

81 patients. 2 patients (50%) with mixed study responded to PPIs. 14 patients (17%) rescued with pathological GER only on the second day of recording.

Full 48h registration: 100% placed capsules (early detachment: 0%)

Overall level of satisfaction: good in 75 patients (92%).

Conclusions:

The endoscopic placement of the capsule is reliable, safe and well tolerated, with a high degree of patient satisfaction.

It allows more longer studies (48h full), helping to rescue patients with GER and normal conventional pH monitoring, in which just the second day of the study shows reflux.

It allows performing mixed studies without/with PPIs.