THE IMPLICATION OF MULTICHANNEL INTRALUMINAL IMPEDANCE AND PH- MONITORING IN GERD PATIENTS

Abstract

Gastroesophageal reflux disease (GERD) is a prevalent condition caused by the retrograde flow of stomach contents into the esophagus, leading to troublesome symptoms and complications. Conventional diagnostic methods, such as proton pump inhibitor (PPI) trials and esophagogastroduodenoscopy, often fail to diagnose refractory GERD effectively. This study explores the utility of combined multichannel intraluminal impedance (MII) and pH monitoring for diagnosing refractory GERD in a 38-year-old female patient with persistent symptoms despite acid suppression therapy. A case study approach was utilized to evaluate the patient using impedance-pH monitoring, measuring reflux episodes, bolus clearance time (BCT), and proximal migration extent. The findings revealed 32 reflux events, primarily weakly acidic liquid reflux, and a DeMeester score of 31.38, indicating mild GERD. Proximal reflux and pathological BCT were identified, confirming refractory GERD. The diagnostic combination of impedance and pH-metry enabled a more precise assessment of reflux patterns, correlating symptoms with reflux events. This study underscores the limitations of standard GERD diagnostic approaches and highlights the advantages of advanced impedance-pH monitoring for refractory GERD. The findings emphasize the importance of personalized diagnostic methods for managing complex GERD cases, ensuring tailored treatment strategies. Further research is recommended to explore the broader applicability of impedance-pH monitoring in diverse GERD presentations. Its integration into clinical practice may enhance diagnostic accuracy and optimize therapeutic outcomes, addressing unmet needs in GERD management.