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  • Title: [Catheter-free pH-metry using the Bravo capsule versus standard pH-metry in patients with non-erosive reflux disease (NERD)].
    Author: Mönkemüller K, Neumann H, Fry LC, Kolfenbach S, Malfertheiner P.
    Journal: Z Gastroenterol; 2009 Apr; 47(4):351-6. PubMed ID: 19358061.
    Abstract:
    BACKGROUND: pH-monitoring is considered the gold standard for the detection of acid reflux in patients with non-erosive reflux disease (NERD). Preliminary pH studies performed over periods longer than 24 hours have shown that in up to one-third of subjects abnormal pH exposure is detected only on the second day of monitoring. Therefore, pH-monitoring during 48 hours may yield more information about pathological acid reflux in patients being investigated for NERD. AIM: The aim of this study was to compare conventional 24-hour pH-monitoring with the new wireless 48-hour Bravo pH-monitoring in patients with NERD. PATIENTS AND METHODS: Patients with typical reflux symptoms, a positive reflux disease questionnaire and negative endoscopy (NERD) and without any form of acid suppressive therapy were included in this prospective study. The patients were divided into two groups: group A for conventional 24-hour pH-monitoring and group B for wireless 48-h Bravo pH-monitoring. RESULTS: 76 patients with a diagnosis of NERD based on a positive RDQ questionnaire and negative endoscopy were included. (47 woman, 29 men, median age: 49 years). 54 underwent conventional pH-monitoring and 22 underwent 48-h pH-monitoring with the new wireless BRAVO system. The overall incidence of acid reflux was 55 % in patients with NERD. Acid reflux was detected less frequently when using Bravo as compared to conventional pH-monitoring. In addition, the Bravo pH-metry showed a large day-to-day variability. CONCLUSIONS: Prolonged pH-monitoring over a period longer than 24 hours did not improve the detection of acid reflux in patients with NERD. Thus, it appears that the Bravo pH-metry does not offer an advantage over standard pH-metry in the daily clinical practice.
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