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Hépato-Gastro & Oncologie Digestive

Wireless pH-monitoring: technical aspects and clinical contribution Volume 19, numéro 1, Janvier 2012

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  • Auteur(s) : Stanislas Bruley des Varannes, Sabine Roman, François Mion, Jean-Christophe Letard, Frank Zerbib , CHU de Nantes, Institut des maladies de l’appareil digestif, CIC-Inserm, Nantes F-44093 France, Université de Nantes, Nantes F-44093 France, Hospices Civils de Lyon, Hôpital Edouard Herriot, physiologie digestive, Lyon, F-69437, France, Université Claude Bernard Lyon 1, Lyon, F-622 France, Polyclinique de Poitiers, 1 rue de la Providence, F-86035 Poitiers, France, CHU de Bordeaux, Hôpital Saint André, département d’hépato-gastroentérologie Bordeaux, F-33075 France, Université Victor Segalen Bordeaux 2, Bordeaux, F-33076, France
  • Mots-clés : esophageal pH monitoring, Bravo <sup>®</sup> capsule, gastro-esophageal reflux disease
  • Page(s) : 21-7
  • DOI : 10.1684/hpg.2012.0672
  • Année de parution : 2012

Currently, the use of esophageal pH-monitoring is rather limited mainly due to technical difficulties. In addition a nasal electrode for 24 h is often responsible of limitation of activities and reduces the diagnostic value of the test. Telemetric wireless pH-monitoring is now available, avoiding these limitations and offering the advantage of prolonged recordings for 48 h or even 96 h. Consequently diagnostic value is increased, especially due to the more frequent occurrence of symptoms during monitoring. This pH-metric capsule should not be used in patients with increased hemorrhagic risk or in those with pacemaker devices. Inserting the wireless pH capsule during an upper GI endoscopic examination is possible thus reducing hospital visits. Several studies have established the reliability of the technique; in addition the inserted capsule on the esophageal wall makes impossible intragastric migration of the probe sometimes observed with conventional electrodes. Tolerance is good with sometimes some transient chest pain. Overall patients feel more comfortable in their daily activities than with conventional wire electrodes. Finally prolonged wireless pH monitoring makes possible in a unique session both diagnostic and therapeutic characterizations by administering an antisecretory agent at mid recording. Consequently wireless pH monitoring is a valuable alternative to conventional pH-monitoring, especially in patients with intermittent and/or atypical symptoms suggestive of reflux.