Faculty Collaboration Database

Impedance signature of pharyngeal gaseous reflux. Eur J Gastroenterol Hepatol 2007 Jan;19(1):65-71

Date

01/09/2007

Pubmed ID

17206079

DOI

10.1097/MEG.0b013e3280117fda

Scopus ID

2-s2.0-33846099093 (requires institutional sign-in at Scopus site)   3 Citations

Abstract

BACKGROUND: Pharyngeal impedance changes induced by various pharyngeal reflux events have not been characterized.

OBJECTIVES: To characterize pharyngeal impedance changes induced by participant-perceived belching events.

METHODS: We systematically evaluated pharyngeal impedance and pH changes related to 453 belch events in 11 gastroesophageal reflux disease, 10 reflux attributed-laryngitis patients and 16 controls.

RESULTS: Of 453 belch events, 362 were analyzable. Of these, 72% occurred within 10 s, 93% within 20 s, 99% within 30 s and 100% within 40 s of the time that participants marked a belch event. In 15% impedance changes in the pharynx preceded, in 12% they were simultaneous and in 73% they occurred after the start of the impedance change in the proximal esophagus. Time interval between the two events ranged between 0.4+/-0.03 and 0.7+/-0.1 s. In all, there were three types of belch-induced impedance changes: (a) impedance increase, (b) impedance decrease and (c) multiphasic. Twenty percent of impedance events associated with belching had less than 50% change from baseline, whereas in 51% changes exceeded or were equal to 50%. Among events with a drop in pharyngeal impedance, only two satisfied the criteria for the liquid reflux event.

CONCLUSIONS: Pharyngeal ventilation of gastric gaseous content seems to have a unique impedance signature. During pharyngeal gas reflux events, impedance changes may start before or after proximal esophageal changes. Belching may induce negative pharyngeal changes that do not meet the criteria for liquid reflux. These findings need to be taken into consideration in the analysis of pharyngeal reflux events.

Author List

Kawamura O, Bajaj S, Aslam M, Hofmann C, Rittmann T, Shaker R

Author

Reza Shaker MD Assoc Provost, Sr Assoc Dean, Ctr Dir, Chief, Prof in the Medicine department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adult
Aged
Electric Impedance
Eructation
Esophageal pH Monitoring
Esophagus
Female
Gastroesophageal Reflux
Humans
Hydrogen-Ion Concentration
Male
Middle Aged
Pharynx
Time Factors