24-Stunden-Ösophagus-pH-Metrie

Zusammenfassung

Die vorliegende Arbeit gibt die Empfehlungen der Deutschen Gesellschaft für Neutrogastroenterologie und Motilität und der Arbeitsgruppe für gastrointestinale Funktionsstörungen und Funktionsdiagnostik der Österreichischen Gesellschaft für Gastroenterologie und Hepatologie zur 24-Stunden-Ösophagus-pH-Metrie wieder. Dargestellt werden die Indikationen für die Untersuchung, ihre praktische Durchführung, die Analyse und Bewertung der gewonnenen Daten sowie die den Empfehlungen zugrunde liegende wissenschaftliche Literatur.

Abstract

This article presents the recommendations for 24-hour oesophageal pH-metry of the German Society of Neurogastroenterology and Motility and the Study Group for Gastrointestinal Functional Disorders and Function Diagnostics of the Austrian Society of Gastroenterology and Hepatology. Indications for the examination, the procedures to be followed, the analysis of the obtained data and the conclusions to be drawn are delineated. The literature on which the recommendations are based is reviewed.

Schlüsselwörter

pH-Metrie - Indikationen - praktische Durchführung - Auswertung

Key words

pH metry - indications - practical aspects - interpretation

Literatur

• 1 Spencer J. Prolonged pH recording in the study of gastro-oesophageal reflux.  Br J Surg. 1969;  56 9-12
• 2 DeMeester T R, Johnson L F, Joseph G J. et al . Patterns of gastroesophageal reflux in health and disease.  Ann Surg. 1976;  184 459-470
• 3 Johnson L F, DeMeester T R. Twenty-four hour pH monitoring of the distal esophagus. A quantitative measure of gastroesophageal reflux.  Am J Gastroenterol. 1974;  62 325-332
• 4 DeVault K R, Castell D O. Updated guidelines for the diagnosis and treatment of gastroesophageal reflux disease.  Am J Gastroenterol. 1999;  94 1434-1442
• 5 Kahrilas P J, Quigley E MM. American Gastroenterological Association medical position statement: Guidelines on the use of esophageal pH recording.  Gastroenterology. 1996;  110 1981-1996
• 6 Demedts I, Tack J, Sifrim D. et al . Gastroesophageal reflux disease refractory to proton pump inhibitors: acid, bile reflux and both?.  Gastroenterology. 1999;  116 A326
• 7 Fass R, Mackel C, Sampliner R E. 24-hour pH monitoring in symptomatic patients without erosive esophagitis who did not respond to antireflux treatment.  J Clin Gastroenterol. 1994;  19 97-99
• 8 Katzka D A, Paoletti V, Leite L. et al . Prolonged ambulatory pH monitoring in patients with persistent gastroesophageal reflux disease symptoms: testing while on therapy identifies the need for more aggressive anti-reflux therapy.  Am J Gastroenterol. 1996;  91 2110-2113
• 9 Lord R VN, Kaminski A, Öberg S. et al . Absence of gastroesophageal reflux disease in a majority of patients taking acid suppression medications after Nissen fundoplication.  J Gastrointest Surg. 2002;  6 3-10
• 10 Scarpignato C, Galmiche J P. (Hrsg) .Functional investigation in esophageal disease. Basel; Karger 1994
• 11 Tytgat G NJ, Bennett J R, Dent J. et al . Oesophageal pH monitoring - normal and abnormal.  Gastroenterology International. 1989;  2 141-149
• 12 Achem S R. Endoscopy-negative gastroesophageal reflux disease.  Gastroenterol Clin North Am. 1999;  28 893-904
• 13 Shi G, Bruley d es Varannes S, Scarpignato C. et al . Reflux related symptoms in patients with normal oesophageal exposure to acid.  Gut. 1995;  37 457-464
• 14 Janssens J P, Vantrappen G. Irritable esophagus.  Am J Med. 1992;  92 (Suppl. 5A) 27-32
• 15 Davies H A. Anginal pain of esophageal origin: clinical presentation, prevalence and prognosis.  Am J Med. 1992;  92(Suppl. 5A) 5S-10S
• 16 DeMeester T R, O’Sullivan G C, Bermudez G. et al . Esophageal function in patients with angina-type chest pain and normal coronary angiograms.  Ann Surg. 1982;  196 488-498
• 17 Fennerty M B. Extraesophageal gastroesophageal reflux disease.  Gastroenterol Clin North Am. 1999;  28 861-873
• 18 Katz P O, Castell D O. Approach to the patient with unexplained chest pain.  Am J Gastroenterol. 2000;  95 (Suppl) 4-8
• 19 Lam H GT, Dekker W, Kann G. et al . Acute noncardiac chest pain in a coronary care unit. Evaluation by 24-hour pressure and pH recording of the esophagus.  Gastroenterology. 1992;  102 453-460
• 20 Lux G, Orth K H, Boskurt T. Nicht-kardialer Thoraxschmerz - eine Erkrankung der Speiseröhre?.  Dtsch Med Wschr. 1995;  120 1748-1755
• 21 Richter J E. Overview of diagnostic testing for chest pain of unknown origin.  Am J Med. 1992;  92 (Suppl. 5A) 41-45
• 22 Singh S, Richter J E, Hewson E G. et al . The contribution of gastroesophageal reflux to chest pain in patients with coronary artery disease.  Ann Intern Med. 1992;  117 824-830
• 23 Smout A JPM, Lam H GTH, Breumelhof R. Ambulatory esophageal monitoring in noncardiac chest pain.  Am J Med. 1992;  92 (Suppl. 5A) 74-83
• 24 Stein H J, DeMeester T R. Therapy of noncardiac chest pain: is there a role for surgery?.  Am J Med. 1992;  92 (Suppl. 5A) 122-128
• 25 Ward B W, Wu W C, Richter J E. et al . Long-term follow-up of symptomatic status of patients with noncardiac chest pain: is diagnosis of esophageal etiology helpful?.  Am J Gastroenterol. 1987;  82 215-218
• 26 Garcia-Pulido J, Patel P H, Hunter W C. et al . Esophageal contribution to chest pain in patients with coronary artery disease.  Chest. 1990;  98 806-810
• 27 Midell A I, Evander A, DeMeester T R. et al .A study of the interrelationship between esophageal disease and coronary artery disease as the cause of chest pain. Siewert JR, Hölscher AH Diseases of the esophagus Berlin, Heidelberg, New York; Springer 1987: 1092-1102
• 28 Davies H A, Page Z, Rush E M. et al . Oesophageal stimulation lowers exertional angina threshold.  Lancet. 1985;  1 1011-1014
• 29 Achem S R, Kolts B E. Current medical therapy for esophageal motility disorders.  Am J Med. 1992;  92 (Suppl.5A) 98-105
• 30 Achem S R, Kolts B E, MacMath T. et al . Effects of omeprazole versus placebo in treatment of noncardiac chest pain and gastroesophageal reflux.  Dig Dis Sci. 1997;  42 2138-2145
• 31 Ormseth E J, Wong R KH. Reflux laryngitis: pathophysiology, diagnosis, and management.  Am J Gastroenterol. 1999;  94 2812-2817
• 32 El-Serag H B, Sonnenberg A. Comorbid occurrence of laryngeal or pulmonary disease with esophagitis in United States military veterans.  Gastroenterology. 1997;  113 755-760
• 33 Hanson D G, Jiang J J. Diagnosis and management of chronic laryngitis associated reflux.  AmMed. 2000;  108 (Suppl. 4A) 112-119
• 34 Wong R KH, Hanson D G, Waring P J. et al . ENT manifestations of gastroesophageal reflux.  Am J Gastroenterol. 2000;  95 (Suppl) S15-S22
• 35 Ing A J. Cough and gastroesophageal reflux.  Am J Med. 1997;  103 (Suppl. 5A) 91-96
• 36 Irwin R S, Madison J M. Anatomical diagnostic protocol in evaluating chronic cough with specific reference to gastroesophageal reflux.  Am J Med. 2000;  108 (Suppl. 4A) 126-130
• 37 Irwin R S, Richter J E. Gastroesophageal reflux and chronic cough.  Am J Gastroenterol. 2000;  95 (Suppl) S9-14
• 38 Irwin R S, Zawacki J K. Accurately diagnosing and successfully treating chronic cough due to gastroesophageal reflux disease can be difficult.  Am J Gastroenterol. 1999;  94 3095-3098
• 39 Ours T M, Kavuru M S, Schilz R J. et al . A prospective evaluation of esophageal testing and a double-blind, randomized study of omeprazole in a diagnostic and therapeutic algorithm for chronic cough.  Am J Gastroenterol. 1999;  94 3131-3138
• 40 Farup P G, Hovde O, Breder O. Are frequent short gastro-oesophageal reflux episodes the cause of symptoms in patients with non-ulcer dyspepsia responding to treatment with ranitidine?.  Scand J Gastroenterol. 1995;  30 829-832
• 41 Klauser A G, Voderholzer W A, Knesewitsch P A. et al . What is behind dyspepsia?.  Dig Dis Sci. 1993;  38 147-154
• 42 Pehl C, Wendl B, Greiner I. et al . Abnormal oesophageal pH-monitoring in patients with functional thoracic and abdominal disorders.  Gastroenterol Clin Biol. 1995;  19 367-372
• 43 Small P K, Loudon M A, Waldron B. et al . Importance of reflux symptoms in functional dyspepsia.  Gut. 1995;  36 189-192
• 44 Lazarchik D A, Filler S J. Dental erosion: predominant oral lesion in gastroesophageal reflux disease.  Am J Gastroenterol. 2000;  95 (Suppl) S33-38
• 45 Lazarchik D A, Filler S J. Effects of gastroesophageal reflux on the oral cavity.  Am J Med. 1997;  103 (Suppl. 5A) 107-113
• 46 Schroeder P L, Filler S J, Ramirez B. et al . Dental erosion and acid reflux disease.  Ann Intern Med. 1995;  122 809-815
• 47 Field S K, Gelfand G AJ, McFadden S D. The effects of antireflux surgery on asthmatics with gastroesophageal reflux.  Chest. 1999;  116 766-774
• 48 Field S K, Sutherland L R. Does medical antireflux therapy improve asthma in asthmatics with gastroesophageal reflux?.  Chest. 1998;  114 275-283
• 49 Field S K, Underwood M, Brant R. et al . Prevalence of gastroesophageal reflux symptoms in asthma.  Chest. 1996;  109 316-322
• 50 Field S K. A critical review of the studies of the effects of simulated or real gastroesophageal reflux on pulmonary function in asthmatic adults.  Chest. 1999;  115 848-886
• 51 Harding S M, Sontag S J. Asthma and gastroesophageal reflux.  Am J Gastroenterol. 2000;  95 (Suppl) S23-32
• 52 Richter J E. Gastroesophageal reflux disease and asthma: the two are directly related.  Am J Med. 2000;  108 (Suppl. 4A) 153-158
• 53 Sontag S J. Gastroesophageal reflux and asthma.  Am J Med. 1997;  103 (Suppl. 5A) 84-90S
• 54 Champion G, Richter J E, Vaezi M F. et al . Duodenogastroesophageal reflux: relationship to pH and importance in Barrett’s esophagus.  Gastroenterology. 1994;  107 747-754
• 55 Vaezi M F, Richter J E. Role of acid and duodenogastroesophageal reflux in gastroesophageal reflux disease.  Gastroenterology. 1996;  111 1192-1199
• 56 Johnson D A, Winters C, Spurling T J. et al . Esophageal acid sensitivity in Barrett’s esophagus.  J Clin Gastroenterol. 1987;  9 23-27
• 57 Katzka D A, Castell D O. Successful elimination of reflux symptoms does not ensure adequate control of acid reflux in Barrett’s esophagus.  Am J Gastroenterol. 1994;  89 989-991
• 58 Ortiz A, de Martinez H aro LF, Parrilla P. et al . 24-h pH monitoring is necessary to assess acid reflux suppression in patients with Barrett’s oesophagus undergoing treatment with proton pump inhibitors.  Br J Surg. 1999;  86 1472-1474
• 59 Ouatu-Lascar R, Fitzgerald R C, Triadafilopoulos G. Differention and proliferation in Barrett’s esophagus and the effects of acid suppression.  Gastroenterology. 1999;  117 327-335
• 60 Ouatu-Lascar R, Triadafilopoulos G. Complete elimination of reflux symptoms does not guarantee normalization of intraesophageal acid reflux in patients with Barrett’s esophagus.  Am J Gastroenterol. 1998;  93 711-716
• 61 Peters F TM, Ganesh S, Kuipers E J. et al . Endoscopic regression of Barrett’s oesophagus during omeprazole treatment: a randomised double blind study.  Gut. 1999;  45 489-494
• 62 Fitzgerald R C, Omary M B, Triadafilopoulos G. Dynamic effects of acid on Barrett’s esophagus: an ex vivo proliferation and differentiation model.  J Clin Invest. 1996;  98 2120-2128
• 63 Peters F T, Ganesh S, Kuipers E J. et al . Effect of elimination of acid reflux on epithelial cell proliferative activity of Barrett esophagus.  Scand J Gastroenterol. 2000;  35 1238-1244
• 64 Srinivasan R, Katz P O, Ramkrishnan A. et al . Maximal acid reflux control for Barrett`s oesophagus.  Aliment Pharmacol Ther. 2001;  15 519-524
• 65 Umansky M, Yasui W, Hallak A. et al . Proton pump inhibitors reduce cell cycle abnormalities in Barrett’s esophagus.  Oncogene. 2001;  29 7987-7991
• 66 Anforderung an die Hygiene bei der Aufbereitung flexibler Endoskope und endoskopischen Zusatzinstrumentariums . Empfehlung der Kommission für Krankenhaushygiene und Infektionsprävention beim Robert Koch-Institut.  Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz. 2002;  45 395-411
• 67 Anforderung an die Hygiene bei der Aufbereitung von Medizinprodukten . Empfehlung der Kommission für Krankenhaushygiene und Infektionsprävention beim Robert-Koch-Institut und des Bundesinstitut für Arzneimittel und Medizinprodukte zu den „Anforderungen an die Hygiene bei der Aufbereitung von Medizinprodukten”.  Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz. 2001;  44 1115-1126
• 68 Emde C, Garner A, Blum A L. Technical aspects of intraluminal pH-metry in man: current status and recommendations.  Gut. 1987;  28 1177-1188
• 69 Galmiche J P, Scarpignato C. Esophageal pH monitoring. Scarpignato C, Galmiche JP Functional investigation in esophageal disease Basel; Karger 1994: 71-108
• 70 Mattox H E, Richter J E. Prolonged ambulatory esophageal pH monitoring in the evaluation of gastroesophageal reflux disease.  Am J Med. 1990;  89 345-356
• 71 McLauchlan G, Buchanan N M, Crean G P. et al . An endoscopic procedure for accurate localisation of intraluminal pH electrodes.  Endoscopy. 1987;  19 124-126
• 72 Vandenplas Y, Helven R, Goyvaerts H. Comparative study of glass and antimony electrodes for continuous oesophageal pH monitoring.  Gut. 1991;  32 708-712
• 73 Ask P, Edwall G, Johansson K E. Accuracy and choice of procedures in 24-hour oesophageal pH monitoring with monocrystalline antimony electrodes.  Med Biol Eng Comput. 1986;  24 602-608
• 74 Richter J E, Bradley L A, DeMeester T R. et al . Normal 24-hr ambulatory esophageal pH values. Influence of study center, pH electrode, age, and gender.  Dig Dis Sci. 1992;  37 849-856
• 75 Anggiansah A, Sumboonnanonda K, Wang J. et al . Significantly reduced acid detection at 10 centimeters compared to 5 centimeters above the lower esophageal sphincter in patients with acid reflux.  AmJ Gastroenterol. 1993;  88 842-846
• 76 Johansson K E, Tibbling L. Evaluation of the 24-hour pH test at two different levels of the esophagus. DeMeester TR, Skinner DB Esophageal disorders: pathophysiology and therapy New York; Raven Press 1985: 579-582
• 77 Lehman G, Rogers D, Cravens E. et al . Prolonged pH probe testing less than 5 cm above the lower esophageal sphincter (LES): Establishing normal control values.  Gastroenterology. 1990;  98 A77
• 78 de Ruiz L eon A, Sevilla-Mantilla C, de la Perez S erna J. et al . Simultaneous two-level esophageal 24-hour pH monitoring in patients with mild and severe esophagitis. Does probe position influence results of esophageal monitoring?.  Dig Dis Sci. 1995;  40 1423-1427
• 79 Shaker R, Dodds W J, Helm J F. et al . Regional esophageal distribution and clearance of refluxed gastric acid.  Gastroenterology. 1991;  101 355-359
• 80 Singh P, Taylor R H, Colin-Jones D G. Simultaneous two level oesophageal pH monitoring in healthy controls and patients with oesophagitis: comparison between two positions.  Gut. 1994;  35 304-308
• 81 DeVault K R, Castell D O. A simplified technique for accurate placement of ambulatory pH probes.  Am J Gastroenterol. 1991;  86 380-381
• 82 Singh S, Price J E, Richter J E. The LES locator: accurate placement of an electrode for 24-hour pH measurement with a combined solid state pressure transducer.  Am J Gastroenterol. 1992;  87 967-970
• 83 Klauser A G, Schindlbeck N E, Müller-Lissner S A. Esophageal 24-h pH monitoring: is prior manometry necessary for correct positioning of the electrode?.  Am J Gastroenterol. 1990;  85 1463-1467
• 84 Klingler P J, Hinder R A, Wetscher G J. et al . Accurate placement of the esophageal pH electrode for 24-hour pH monitoring using a combined pH/manometry probe.  Am J Gastroenterol. 2000;  95 906-909
• 85 Marples M I, Mughal M, Bancewicz J. Can an esophageal pH electrode be accurately positioned without manometry?. Siewert JR, Hoelscher AH Diseases of the esophagus Berlin, Heidelberg, New York; Springer 1987: 789-791
• 86 Mattox H E, Richter J E, Sinclair J W. et al . Gastroesophageal pH step-up inaccurately locates proximal border of lower esophageal sphincter.  Dig Dis Sci. 1992;  37 1185-1191
• 87 Pehl C, Boccali I, Wendl B. et al . Results of dual probe pH-metry with probe positioning either by manometry or pH step-up in healthy volunteers and patients with gastroesophageal reflux disease.  Gut. 1999;  45 (Suppl. V) A46
• 88 Rokkas T H, Anggiansah A, Dorrington L. et al . Accurate positioning of the pH-probe in the oesophagus without manometry.  Ital J Gastroenterol. 1987;  19 176-178
• 89 Walther B, DeMeester T R. Placement of the esophageal pH electrode for 24-hour esophageal pH monitoring. DeMeester TR, Skinner DB Esophageal disorders: Pathophysiology and therapy New York; Raven Press 1985: 539-541
• 90 DA Vincent J r, Garrett J D, Radionoff S L. et al . The proximal probe in esophageal pH monitoring: development of a normative database.  J Voice. 2000;  14 247-254
• 91 Williams R BH, Ali G N, Wallace K L. et al . Esophagopharyngeal acid regurgitation: dual pH monitoring criteria for its detection and insights into mechanisms.  Gastroenterology. 1999;  117 1051-1061
• 92 Ulualp S O, Toohill R J, Shaker R. Pharyngeal acid reflux in patients with single and multiple otolaryngologic disorders.  Otolaryngol Head Neck Surg. 1999;  121 725-730
• 93 Ergun G A, Kahrilas P J. Clinical applications of esophageal manometry and pH monitoring.  Am J Gastroenterol. 1996;  91 1077-1089
• 94 Hendrix T R. pH monitoring: is it the gold standard for the detection of gastroesophageal reflux disease?.  Dysphagia. 1993;  8 122-124
• 95 Clark C S, Kraus B B, Sinclair J. et al . Gastroesophageal reflux induced by exercise in healthy volunteers.  JAMA. 1989;  261 3599-3601
• 96 Shawdon A. Gastro-oesophageal reflux and exercise. Important pathology to consider in the athletic population.  Sports Med. 1995;  20 109-116
• 97 Richter J E. Ambulatory esophageal pH monitoring.  Am J Med. 1997;  103 (Suppl. 5A) 130-134
• 98 Savarino V, Mela G S, Zentilin P. et al . Esophageal pH monitoring: factors influencing the definition of normality.  Minerva Chir. 1991;  46 103-109
• 99 Wo J M, Castell D O. Exclusion of meal periods from ambulatory 24-hour pH monitoring may improve diagnosis of esophageal acid reflux.  Dig Dis Sci. 1994;  39 1601-1607
• 100 Shay S S, Conwell D L, Mehindru V. et al . The effect of posture on gastroesophageal reflux event frequency and composition during fasting.  Am J Gastroenterol. 1996;  91 54-60
• 101 Jamieson J R, Stein H J, DeMeester T R. et al . Ambulatory 24-h esophageal pH monitoring: Normal values, optimal thresholds, specificity, sensitivity, and reproducibility.  Am J Gastroenterol. 1992;  87 1102-1111
• 102 Bianchi P orro G, Pace F. Comparison of three methods of intraesophageal pH recordings in the diagnosis of gastroesophageal reflux.  Scand J Gastroenterol. 1988;  23 743-750
• 103 Dhiman R K, Saraswat V A, Mishra A. et al . Inclusion of supine period in short-duration pH monitoring is essential in diagnosis of gastroesophageal reflux disease.  Dig Dis Sci. 1996;  41 764-772
• 104 Dobhan R, Castell D O. Prolonged intraesophageal pH monitoring with 16-hr overnight recording. Comparison with ‘24-hr’ analysis.  Dig Dis Sci. 1992;  37 857-864
• 105 Fink S M, McCallum R W. The role of prolonged esophageal pH monitoring in the diagnosis of gastroesophageal reflux.  JAMA. 1984;  252 1160-1164
• 106 Grande L, Pujol A, Ros E. et al . Intraesophageal pH monitoring after breakfast + lunch in gastroesophageal reflux.  J Clin Gastroenterol. 1988;  10 373-376
• 107 Jorgensen F, Elsborg L, Hesse B. The diagnostic value of computerized short-term oesophageal pH-monitoring in suspected gastrooesophageal reflux.  Scand J Gastroenterol. 1988;  23 363-368
• 108 Schindlbeck N E, Ippisch H, Klauser A G. et al . Which pH threshold is best in esophageal pH monitoring.  Am J Gastroenterol. 1991;  86 1138-1141
• 109 Dinelli M, Passaretti S, Di Francia I. et al . Area under pH 4: a more sensitive parameter for the quantitative analysis of esophageal acid exposure in adults.  Am J Gastroenterol. 1999;  94 3139-3144
• 110 Ter R B, Johnston B T, Castell D O. Exclusion of meal period improves the clinical reliability of esophageal pH monitoring.  J Clin Gastroenterol. 1997;  25 314-316
• 111 Tovar J A, Izquierdo M A, Eizaguirre I. The area under pH curve: a single-figure parameter representative of esophageal acid exposure.  J Pediatr Surg. 1991;  26 163-167
• 112 Vandenplas Y, Franckx-Gossens A, Pipeleers-Marichal M. et al . Area under pH 4: advantages of a new parameter in the interpretation of esophageal pH monitoring data in infants.  J Pediatr Gastroenterol Nutr. 1989;  9 34-39
• 113 Johnson L F, DeMeester T R. Development of the 24-hour intraesophageal pH monitoring composite scoring system.  J Clin Gastroenterol. 1986;  8 (Suppl. 1) 52-58
• 114 Schindlbeck N E, Heinrich C, König A. et al . Optimal thresholds, sensitivity, and specificity of long-term pH-metry for the detection of gastroesophageal reflux disease.  Gastroenterology. 1987;  93 85-90
• 115 Vandenplas Y, Helven R, Goyvaerts H. et al . Reproducibility of continuous 24 hour oesophageal pH monitoring in infants and children.  Gut. 1990;  31 374-377
• 116 Ward B W, Wu W C, Richter J E. et al . Ambulatory 24-hour esophageal pH monitoring. technology searching for a clinical application.  J Clin Gastroenterol. 1986;  8 (Suppl. 1) 59-67
• 117 Wiener G J, Morgan T M, Copper J B. et al . Ambulatory 24-hour esophageal pH monitoring. Reproducibility and variability of pH parameters.  Dig Dis Sci. 1988;  33 1127-1133
• 118 Parilla P, de Martinez H aro LF, Ortiz A. et al . Can pH recordings suggest defective esophageal peristalsis in patients with gastroesophageal reflux.  Scand J Gastroenterol. 1992;  27 929-932
• 119 Stanciu C, Bennett J R. Oesophageal acid clearing: one factor in the production of reflux oesophagitis.  Gut. 1974;  15 852-857
• 120 Orenstein S R, Izadnia F, Khan S. Gastroesophageal reflux disease in children.  Gastroenterol Clin North Am. 1999;  28 947-969
• 121 Vandenplas Y, Goyvaerts H, Helven R. et al . Gastroesophageal reflux, as measured by 24-hour pH monitoring, in 509 healthy infants screened for risk of sudden infant death syndrome.  Pediatrics. 1991;  88 834-840
• 122 Boesby S. Continuous oesophageal pH recording and acid-clearing test. A study of reproducibility.  Scand J Gastroenterol. 1977;  12 245-247
• 123 Bontempo I, Corazziari E, Tosoni M. et al . Reproducibility of esophageal pH-metric measurements.  Gastroenterology. 1985;  88 A1331
• 124 Hampton F J, MacFayden U M, Simpson H. Reproducibility of 24 hour oesophageal pH studies in infants.  Arch Dis Child. 1990;  65 1249-1254
• 125 Herrera J L, Simpson I II JK, Maydonovitch C L. et al . Comparison of stationary vs ambulatory 24-hour pH monitoring recording systems.  Dig Dis Sci. 1988;  33 385-388
• 126 Johnsson F, Joelsson B. Reproducibility of ambulatory oesophageal pH monitoring.  Gut. 1988;  29 886-889
• 127 Hampton F J, MacFayden U M, Mayberry J F. Variations in results of simultaneous ambulatory esophageal pH monitoring.  Dig Dis Sci. 1992;  37 506-512
• 128 128 M urphy DW, Faust K B, Chiantella V M. et al . Assessment of accuracy of intraesophageal pH probe in a dog model.  Dig Dis Sci. 1989;  34 1079-1084
• 129 Murphy D W, Yuan Y, Castell D O. Does the intraesophageal pH probe accurately detect acid reflux? Simultaneous recording with two pH probes in humans.  Dig Dis Sci. 1989;  34 649-656
• 130 Patti M G, Diener U, Tamburini A. et al . Role of esophageal function tests in diagnosis of gastroesophageal reflux disease.  Dig Dis Sci. 2001;  46 597-602
• 131 Dobhan R, Castell D O. Normal and abnormal proximal esophageal acid exposure: results of ambulatory dual-probe pH monitoring.  Am J Gastroenterol. 1993;  88 25-29
• 132 Johnston B T, Collins J SA, McFarland R J. et al . Are esophageal symptoms reflux-related? A study of different scoring systems in a cohort of patients with heartburn.  Am J Gastroenterol. 1994;  89 497-502
• 133 Watson R GP, Tham T CK, Johnston B T. et al . Double-blind cross-over placebo controlled study of omeprazole in the treatment of patients with reflux symptoms and physiological levels of acid reflux - the ‘sensitive oesophagus’.  Gut. 1997;  40 587-590
• 134 Baldi F, Ferrarini F, Longanesi A. et al . Acid gastroesophageal reflux and symptom occurrence. Analysis of some factors influencing their association.  Dig Dis Sci. 1989;  34 1890-1893
• 135 Weusten B LAM, Akkermans L MA, vanBerge-Henegouwen G P. et al . Symptom perception in gastroesophageal reflux disease is dependent on spatiotemporal reflux characteristics.  Gastroenterology. 1995;  108 1739-1744
• 136 Smith J L, Opekun A R, Larkai E. et al . Sensitivity of the esophageal mucosa to pH in gastroesophageal reflux disease.  Gastroenterology. 1989;  96 683-689
• 137 Rodriguez-Stanley S, Robinson M, Earnest D L. et al . Esophageal hypersensitivity may be a major cause of heartburn.  Am J Gastroenterol. 1999;  94 628-631
• 138 Fass R, Pulliam G, Johnson C. et al . Symptom severity and oesophageal chemosensitivity to acid in older and young patients with gastrooesophageal reflux.  Age Aging. 2000;  29 125-130
• 139 Bradley L A, Richter J E, Pulliam T J. et al . The relationship between stress and symptoms of gastroesophageal reflux: the influence of psychological factors.  Am J Gastroenterol. 1993;  88 11-19
• 140 Johnston B T, Lewis S A, Love A HG. Psychological factors in gastrooesophageal reflux disease.  Gut. 1995;  36 481-482
• 141 Trimble K C, Pryde A, Heading R C. Lowered oesophageal sensory thresholds in patients with symptomatic but not excess gastrooesophageal reflux: evidence for a spectrum of visceral sensitivity in GORD.  Gut. 1995;  37 7-12
• 142 Fass R, Naliboff B, Higa L. et al . Differential effect of long-term esophageal acid exposure on mechanosensitivity and chemosensitivity in humans.  Gastroenterology. 1998;  115 1363-1373
• 143 Breumelhof R, Nadorp J HSM, Akkermans L MA. et al . Analysis of 24-hour esophageal pressure and pH data in unselected patients with noncardiac chest pain.  Gastroenterology. 1990;  99 1257-1264
• 144 Ghillebert G, Janssens J, Vantrappen G. et al . Ambulatory 24 hour intraoesophageal pH and pressure recordings v provocation tests in the diagnosis of chest pain of oesophageal origin.  Gut. 1990;  31 738-744
• 145 Lam H GT, Breumelhof R, Roelofs J MM. et al . What is the optimal time window in symptom analysis of 24-hour esophageal pressure and pH data?.  Dig Dis Sci. 1994;  39 402-409
• 146 Peters L, Maas L, Petty D. et al . Spontaneous noncardiac chest pain. Evaluation by 24-hour ambulatory esophageal motility and pH monitoring.  Gastroenterology. 1988;  94 878-886
• 147 Soffer E E, Scalabrini P, Wingate D L. Spontaneous noncardiac chest pain: value of ambulatory esophageal pH and motility monitoring.  Dig Dis Sci. 1989;  34 1651-1655
• 148 Singh S, Richter J E, Bradley L A. et al . The symptom index. Differential usefulness in suspected acid-related complaints of heartburn and chest pain.  Dig Dis Sci. 1993;  38 1402-1408
• 149 Wiener G J, Richter J E, Copper J B. et al . The symptom index: a clinically important parameter of ambulatory 24-hour esophageal pH monitoring.  Am J Gastroenterol. 1988;  83 358-361
• 150 Hewson E G, Sinclair J W, Dalton C B. et al . Acid perfusion test: does it have a role in the assessment of noncardiac chest pain?.  Gut. 1989;  30 305-310
• 151 Howard P J, Maher L, Pryde A. et al . Symptomatic gastro-oesophageal reflux, abnormal oesophageal acid exposure, and mucosal acid sensitivity are three separate, though related, aspects of gastrooesophageal reflux disease.  Gut. 1991;  32 128-132
• 152 Johnsson F, Joelsson B, Gudmundsson K. et al . Symptoms and endoscopic findings in the diagnosis of gastroesophageal reflux disease.  Scand J Gastroenterol. 1987;  22 714-718
• 153 Breumelhof R, Smout A JPM. The symptom sensitivity index: a valuable additional parameter in 24-hour esophageal pH recording.  Am J Gastroenterol. 1991;  86 160-164
• 154 Lloyd D A, Borda I T. Food-induced heartburn: Effect of osmolality.  Gastroenterology. 1981;  80 740-741
• 155 Price S F, Smithson K W, Castell D O. Food sensitivity in reflux esophagitis.  Gastroenterology. 1978;  75 240-243
• 156 Yeoh K G, Ho K Y, Guan R. et al . How does chili cause upper gastrointestinal symptoms? A correlation study with esophageal mucosal sensitivity and esophageal motility.  J Clin Gastroenterol. 1995;  21 87-90
• 157 Vela M F, Camacho-Lobato L, Srinivasan R. et al . Simultaneous intraesophageal impedance and pH measurement of acid and nonacid reflux: effect of omeprazole.  Gastroenterology. 2001;  120 1599-1606
• 158 Weusten B LAM, Roelofs J MM, Akkermans L MA. et al . The symptom-association probability: an improved method for symptom analysis of 24-hour esophageal pH data.  Gastroenterology. 1994;  107 1741-1745
• 159 Armstrong D, Emde C, Inauen W. et al . Diagnostic assessment of gastroesophageal reflux disease: what is possible vs what is practical.  Hepatogastroenterology. 1992;  39 (Suppl. 1) 3-13
• 160 Emde C, Armstrong D, Blum A L. Chest pain due to gastroesophageal reflux: presentation of a mathematical procedure to assess its significance.  J Gastrointest Motil. 1990;  2 140
• 161 Sacher-Huvelin S, Gournay J, Amouretti M. et al . Oesophage acido-sensible: histoire naturelle et retentissement sur la qualité de vie. Comparaison avec le reflux gastro-oesophagien. [Acid-sensitive esophagus: natural history and effect on the quality of life. Comparison with gastroesophageal reflux].  Gastroenterol Clin Biol. 2000;  24 911-916
• 162 Bell R, Hanna P, Brubaker S. Laparoscopic fundoplication for symptomatic but physiologic gastroesophageal reflux.  J Gastrointest Surg. 2001;  5 462-467
• 163 Biacabe B, Gleich L L, Laccourreye O. et al . Silent gastroesophageal reflux disease in patients with pharyngolaryngeal cancer: further results.  Head Neck. 1998;  20 510-514
• 164 Freije J E, Beatty T W, Campbell B H. et al . Carcinoma of the larynx in patients with gastroesophageal reflux.  Am J Otolaryngol. 1996;  17 386-390
• 165 Hogan W J. Spectrum of supraesophageal complications of gastroesophageal reflux disease.  Am J Med. 1997;  103 (Suppl. 5A) 77-83
• 166 Johanson J F. Epidemiology of esophageal and supraesophageal reflux injuries.  Am J Med. 2000;  108 (Suppl. 4A) 99-103
• 167 McNally P R, Maydonovitch C L, Prosek R A. Hoarseness and gastroesophageal reflux: what is the relationship?.  Dig Dis Sci. 1989;  34 1900-1904
• 168 Morrison M D. Is chronic gastroesophageal reflux a causative factor in glottic carcinoma?.  Otolaryngol Head Neck Surg. 1988;  99 370-373
• 169 Tobin R W, Pope C E, Pellegrini C A. et al . Increased prevalence of gastroesophageal reflux in patients with idiopathic pulmonary fibrosis.  Am J Respir Crit Care Med. 1998;  158 1804-1808
• 170 Toohill R J, Kuhn J C. Role of refluxed acid in pathogenesis of laryngeal disorders.  AM J Med. 1997;  103 (Suppl. 5A) 100-106
• 171 Ward P H, Hanson D G. Reflux as an etiological factor of carcinoma of the laryngopharynx.  Laryngoscope. 1988;  98 1195-1199

1 * Ehemals Arbeitskreis für Neurogastroenterologie und Motilität der Deutschen Gesellschaft für Verdauungs- und Stoffwechselkrankheiten.