ZepHr® Impedance/pH Reflux Monitoring System

Reflux monitoring, whether pH or impedance/pH, has advantages and drawbacks. The recently updated ACG Practice Guidelines for Diagnosis and Management of GERD provide a simple, yet comprehensive reflux monitoring test selection algorithm¹.

What to know about reflux monitoring.

While an empiric PPI trial remains the first-line diagnostic test in suspected GERD patients, nearly 40% of these patients on PPI treatment continue to experience symptoms².

• A second-line diagnostic test, upper endoscopies are appropriate to determine the extent of esophageal damage. However, over 70% of these are negative³.

• Today’s clinicians have additional diagnostic tools available to help them understand these endoscopy-negative patients with persistent symptoms.

When to choose impedance/pH monitoring?

Patients on PPIs who continue to experience symptoms such as cough, heartburn, regurgitation and chest pain are often difficult to diagnose using traditional pH monitoring. These PPI-refractory, endoscopy-negative patients are optimal candidates for impedance/pH reflux monitoring. In fact, physicians using only acid pH monitoring may miss up to 35% of patients with non-acid reflux.

• The sensitivity of pH-only monitoring in patients with endoscopy-negative reflux symptoms is <71%.
• According to a consensus study by Sifrim et al, when impedance testing is added to pH monitoring, the sensitivity of reflux monitoring approaches 90%^4.