Kết quả đo pH trong kháng thực quản 24 giờ ở bệnh nhân được chẩn đoán GERD không đáp ứng với PPI

Background: Esophageal pH- Impedance testing is considered the gold standard for the diagnosis of gastroesophageal reflux disease (GERD). However, the pH impedance testing metrics are regional differences and system-related [1]. Moreover, the data of this test were mostly collected from Western populations, with none from Vietnamese individuals. In addition, esophageal pH- Impedance testing is not widely available; therefore, many patients came to our hospital presenting with GERD symptoms and took proton pump inhibitors (PPIs) in several years without response. Objectives: This study aims to analyse the esophageal pH impedance testing results and describe the common characteristics of these patients. Methods: A prospective study was conducted on patients who have GERD symptoms and had a diagnosis of GERD but did not respond to PPI trial and at the time of enrollment they underwent esophageal pH impedance testing. The data were analysed by using IBM SPSS Statistics 26 software. Results: 54 patients were enrolled from July 2022 to March 2024. Female/Male ratio was 1,57/1. Most patients had normal BMI: (72,2%). The mean time interval from onset to the testing day was 2,9 years (8 months - 15 years). The main symptom was regurgitation (12 patients, 22,2%), globus (10 patients, 18,5%), chronic cough (8 patients, 14,8%), heartburn and dysphagia (5 patients, 9,3%), hypersalivation and bitter mouth (4 patients, 7,4%), belching (3 patients, 5,6%), dry mouth, burning mouth and hiccup (1 patient 1,9%). Thirty-one patients had sleep disorders (57,4%). The mean GerdQ was 7,52 (3 - 13). The most frequent comorbidity was mental disorders followed by thyroid and heart diseases. EGDs were normal in 40 patients (70,1%) and LA-A in 14 patients (25,9%). Only 4 patients had hiatus hernia (7,4%). Thirty-seven patients had performed HRM (68,5%). Of those, 21 patients had normal results (56,8%), 8 patients had IEM (21,6%), 7 patients had EGJOO (18,9%), 1 patient had achalasia (2,7%). The mean EAT was 0,789% (0% - 6,8%). The mean refluxes was 36,8 (3 - 116). The mean DeMeester score was 3,39 (0,8 - 21,8). The mean MNBI was 2586 ohms (896 ohms - 6725 ohms). Using the Lyon 2.0 criteria, only 1 Patient was diagnosed with GERD (1,85%), 2 patients had borderline thresholds (3,70%), 51 patients were excluded from a GERD diagnosis (94,45%). Conclusions: Ninety-four point four five percent of patients who have GERD symptoms and had diagnosed with GERD previously but did not respond to PPI therapy were excluded GERD.