Evolution of the Probe Methods of Examination in Gastroenterology: Review and Own Researchs

Yu.M. Stepanov, L.M. Mosiychuk, I.V. Kushnirenko

Abstract


Article deals with a review of contemporary methods that provide the ability to determine the functional state of the stomach, esophagus. Due to the improvement of modern research methods, methods that are capable of graphic registration of physiological processes are particularly important.
Progression of technical capabilities contributed to the development of techniques, the essence of which lies in the long-term recording of sensors located on the intracavitary catheters. Thus, the method of endocavitary pH-measurement facilitates the diagnosis of intragastric pH and, very importantly, intraesophageal. Until now, the method of intraesophageal pH-monitoring was considered the «gold standard» for the diagnosis of gastroesophageal reflux disease (GERD). The results of own researches of intraesophageal pH-monitoring in patients with GERD are provided. But many hours of pH monitoring of the esophagus showed only acid reflux, but alkaline and slightly alkaline refluxes remain outside of this method of investigation, so for the final identification of the causes of GERD symptoms the technique of impedance-pH-monitoring is being proposed. Impedance-pH-monitoring was proposed in 1991 by J. Silny as a method based on the evaluation of the motion of fluid, gas in the esophageal lumen by multiple impedance measurement with simultaneous registration of the pH. Technical capabilities of the impedance-pH-monitoring enabled to broaden our understanding of the physiological processes in the esophageal lumen and to determine the role of mixed, alkaline reflux in the development of GERD symptoms. This article presents the results of several studies conducted in different groups of patients with pathology of the upper digestive tract, which showed the superiority of impedance pH-monitoring and its high level of sensitivity and specificity in terms of reflux detection. The widespread introduction of new techniques and technologies into clinical practice will improve the efficiency and timeliness of medical care, avoiding time consuming for the selection of therapy, evaluation of its effectiveness.


Keywords


esophagus; motility; secretion; pH-monitoring; impedance

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DOI: https://doi.org/10.22141/2308-2097.1 (51).2014.81924

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