Esophageal chemical clearance and baseline impedance values in patients with chronic autoimmune atrophic gastritis and gastro-esophageal reflux disease

摘要

Abstract Background The factors influencing new markers of gastro-esophageal reflux disease detected by impedance-pH monitoring – mean nocturnal baseline impedance (MNBI) and post-reflux swallow-induced peristaltic wave (PSPW) index – need to be evaluated. Aim To compare endoscopy-negative heartburn with chronic autoimmune atrophic gastritis (CAAG). Materials and methods 24 patients with CAAG, 25 with non-erosive reflux disease (NERD) and 25 with functional heartburn (FH) were included. In all patients the main impedance-pH monitoring parameters were calculated. Results CAAG and NERD patients had a number of reflux events (non-acid ones being more common among the former group) which was higher than that found in FH (p 0.001). MNBI decreased progressively in FH (3000 Ohm), CAAG (2000 Ohm) and NERD (1000 Ohm) patients (p = 0.0046). The PSPW index was similar between CAAG and NERD patients but significantly lower in comparison to FH (p 0.0001). Conclusion Patients with CAAG have evidence of non-acid reflux based on the high number of reflux events and confirmed by low values of MNBI and PSPW index. MNBI is a strong marker of acid/non-acid reflux-induced mucosal damage, whereas the PSPW index can reliably discriminate patients with reflux from those with FH, independently of the acidity of refluxate. ]]>