Ambulatory pH Monitoring Methodology

  title={Ambulatory pH Monitoring Methodology},
  author={Gregory N. Postma},
  journal={Annals of Otology, Rhinology \& Laryngology},
  pages={10 - 14}
  • G. Postma
  • Published 1 October 2000
  • Medicine
  • Annals of Otology, Rhinology & Laryngology
Twenty-four-hour ambulatory double-probe pH monitoring is the current “gold standard” for the evaluation of gastroesophageal and extraesophageal reflux. The following article seeks to characterize some of the areas of controversy and describes the methodology of ambulatory pH monitoring used at the Center for Voice Disorders of Wake Forest University. 
Design and Implementation of an Ambulatory pH Monitoring Protocol in Patients with Suspected Laryngopharyngeal Reflux
Adding a hypopharyngeal sensor to esophageal pH monitoring has been advocated for laryngopharynGEal reflux (LPR), but selecting the proper pH catheter is problematic because esophagal lengths are variable among individuals.
Ambulatory 24‐Hour Double‐Probe pH Monitoring: The Importance of Manometry
Evaluated the accuracy of DVP for pH probe placement using manometric measurement as the gold standard, and there appears to be no way to accurately position the distal probe.
Pepsin and oropharyngeal pH monitoring to diagnose patients with laryngopharyngeal reflux
The aim of this study was to compare the diagnostic accuracy of salivary pepsin with oropharyngeal pH monitoring using the Restech measurement system (Dx‐pH) for the diagnosis of laryngopharyngeal
Extraesophageal Reflux: What Is the Best Parameter for pH-Monitoring Data Analysis from the Perspective of Patient Response to Proton Pump Inhibitors?
Patients with EER diagnosed using AET or RAI will respond to PPI significantly often, and Statistically significant, often positive PPI trials were confirmed in the group identified as having substantial EER using all three types of analysis.
Assessment of respiratory symptoms with dual pH monitoring in patients with gastro‐oesophageal reflux disease
Investigation of acid reflux in healthy volunteers and patients with GORD with and without respiratory symptoms was investigated by dual pH monitoring.
Monitoring of Laryngopharyngeal Reflux: Influence of Meals and Beverages
Ambulatory 24-hour double-probe pH monitoring seems to be the best test to measure reflux, but the registration of laryngopharyngeal reflux was severely biased by intake of food and beverages and other artifacts and leaving out meals and beverages did not correct for all artifacts.
Normal values in ambulatory oesophageal pH monitoring at two levels in Spain.
  • F. Azpiroz, J. Baudet, M. J. Soria
  • Medicine
    Revista espanola de enfermedades digestivas : organo oficial de la Sociedad Espanola de Patologia Digestiva
  • 2010
This is the largest series of normal values of proximal oesophageal reflux that confirm the existence of acid reflux at that level in healthy subjects, in small quantity and unrelated to age or gender.
Tetra-probe, 24-hour pH monitoring for laryngopharyngeal reflux: a technique for simultaneous study of hypopharynx, oesophagus and stomach
Tetra-probe, 24-hour pH monitoring is a reliable functional examination for laryngopharyngeal reflux, enabling gastric acid levels and patterns of reflux to be assessed and to evaluate anti-reflux medication efficacy.
Patterns of laryngopharyngeal and gastroesophageal reflux
It is valid to use a pH level of 5.0 as indicative of laryngopharyngeal reflux in the hypopharynx, even though there is no consensus on how to interpret the data collected.
Nasal Pepsin Assay and pH Monitoring in Chronic Rhinosinusitis
The relationship between chronic rhinosinusitis (CRS) and laryngopharyngeal reflux (LPR) and the diagnostic value of pepsin in nasal lavage was investigated by means of fluorometric assay as compared with 24‐hour dual‐probe pH monitoring.


Ambulatory esophageal pH monitoring.
  • J. Richter
  • Medicine
    The American journal of medicine
  • 1997
Ambulatory pH Measurements at the Upper Esophageal Sphincter
A new, easy, and reliable technique for the placement of the proximal probe without the use of manometry and the establishment of normal ranges for pH values a t the level of the UES is described.
Reproducibility of proximal probe pH parameters in 24-hour ambulatory esophageal pH monitoring.
The proximal pH probe has excellent specificity but poorer sensitivity and reproducibility for identifying abnormal amounts of proximal esophageal acid reflux, and a negative test result does not exclude proximal reflux with microaspiration as a cause of atypical reflux symptoms.
Extraesophageal pediatric reflux: 24-hour double-probe pH monitoring of 222 children.
The data suggest that extraesophageal reflux may be underestimated by single-probe intraesophagal monitoring alone, and that laryngopharyngealReflux may play a role in the pathogenesis of the conditions studied.
Gastroesophageal reflux and asthma: a possible reflex mechanism.
The technique employed and the prompt reversal of pulmonary functions suggest reflex mechanisms may be producing the observed bronchoconstriction in asthmatic patients with gastroesophageal reflux.
Normal and abnormal proximal esophageal acid exposure: results of ambulatory dual-probe pH monitoring.
Minimal acid exposure occurred in the proximal esophagus in volunteers and patients with normal distal reflux and Patients with abnormal distal acid exposure had significantly greater proximal reflux.
Spatiotemporal characteristics of physiological gastroesophageal reflux.
It was concluded that ambulatory multichannel esophageal pH monitoring using ISFET technology is a valuable tool for studies on the spatio-temporal characteristics of gastroesophageaal reflux.
Gastroesophageal reflux-induced bronchoconstriction. An intraesophageal acid infusion study using state-of-the-art technology.
Intraesophageal acid infusions caused a decrease in PEF in all groups without evidence of microaspiration, implying a vagally mediated reflex may be involved, and the effects were not dependent on a positive Bernstein test or evidence of proximal reflux.
Ambulatory esophageal and hypopharyngeal pH monitoring in patients with hoarseness.
  • P. Katz
  • Medicine
    The American journal of gastroenterology
  • 1990
Hypopharyngeal reflux (pH drop less than 4 in upper electrode preceded by pH drop lessthan 4 in esophageal electrode) was conclusively demonstrated in 7 of 10 patients and is useful in the diagnosis of reflux-induced hoarseness.