24-Stunden-pH-Impedanzmessung

Zusammenfassung

Eine gastroösophageale Refluxkrankheit (GÖRK) liegt vor, wenn der Reflux von Mageninhalt in den Ösophagus belastende Symptome oder Komplikationen verursacht. Dies beinhaltet sowohl intestinale Symptome wie Sodbrennen als auch extraintestinale insbesondere pulmonale Symptome wie chronischen Husten oder bronchiale Obstruktion. Zu unterscheiden ist dies vom physiologischen Reflux, der vor allem im Säuglingsalter eine hohe Prävalenz zeigt. Bestimmte Grunderkrankungen prädisponieren zur GÖRK, z. B. chronische Lungenerkrankungen und schwere psychomotorische Behinderungen. Den Goldstandard in der Diagnostik stellte die 24-h-pH-Metrie dar. Seit 2004 ist ein neues Verfahren, die 24-h-pH-Impedanzmessung, kommerziell erhältlich. Hier wird der Reflux als retrograde Bolusbewegungen unabhängig vom pH erfasst. Besonders bei der Beurteilung des zeitlichen Zusammenhangs zwischen Re-flux und auftretenden Symptomen ist sie der pH-Metrie überlegen, da auch nicht saurer Re-flux erfasst wird. Profitieren können von dieser Untersuchung vor allem Kinder mit nicht klassischen, extraintestinalen Refluxsymptomen sowie Patienten mit fehlender Symptom-besserung unter einer säuresupprimierenden Therapie.

Summary

Gastroesophageal reflux disease (GERD) is present when the reflux of gastric contents causes troublesome symptoms or complications. These include intestinal symptoms like heartburn and extraintestinal symptoms like chronic cough or wheezing. GERD should be distinguished from physiological reflux, which shows a high prevalence especially in infants. Certain underlying conditions predis-pose for severe-chronic GERD such as chronic respiratory disorders or neurological impairment. The gold standard in GERD-diagnostic used to be 24-hours-pH-measurement. Since 2004 a new technique, the 24-hours intraluminal multichannel-pH-measurement is commercially available. This method registers reflux episodes as retrograde bolus movements and is pH-independent. It is superior to pH monitoring alone for evaluation of the temporal relation between symptoms and re-flux since it also registers non-acidic reflux events. Especially children with non-classical, extraintestinal reflux symptoms and patients who do not respond to acid suppressive treatment can profit from this new method.

Schlüsselwörter

Gastroösophageale Refluxkrankheit - pH-Metrie - Impedanzmessung

Keywords

Gastroesophageal reflux - pH-measurement - multiple intraluminal impedance

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