Gutschow Christian A, Bollschweiler Elfriede, Schröder Wolfgang, Collet Peter, Collard Jean-Marie, Hölscher Arnulf H
Department of Visceral and Vascular Surgery, University of Cologne, Cologne, Germany.
J Gastrointest Surg. 2005 Apr;9(4):508-13. doi: 10.1016/j.gassur.2004.09.035.
With introduction of the Bilitec 2000 device, intraluminal bile monitoring has become a standard technique for evaluation of patients with gastroesophageal reflux disease and symptoms of bile reflux. A specific "white diet" excluding colored food is necessary to provide correct measurements. The influence of this specific diet on simultaneous esophageal pH monitoring is unknown. Forty patients with reflux symptoms were studied prospectively. Meal times and supine and erect phases of measurement were recorded in a standardized fashion using a patient protocol. Esophageal 24-hour pH monitoring with administration of a "colorless" diet (water, milk, potatoes, fish, chicken) was started on day 1, followed by esophageal 24-hour pH-metry with intake of a normal diet on day 2. Data from the two successive pH measurements were compared. The prevalence of a pathologic esophageal pH-metry was significantly higher during intake of a normal diet compared with a colorless diet (P=0.025). During total and upright phases, administration of a white diet led to significant reduction in the percentage of time with a pH less than 4 (P </= 0.01), the total number of reflux episodes (P </= 0.001), and the DeMeester's score (P=0.01). This difference was exclusively found in patients with a normal pH-metry (group 1, n=13) and pathologic upright reflux (group 2, n=12). No change in reflux pattern was found in patients with isolated supine reflux (group 3, n=7) and combined upright and supine reflux (group 4, n=8). In patients with a pathologic upright reflux pattern, administration of a white diet results in a significant modification of esophageal pH-metry. Data derived from simultaneous esophageal pH and bile monitoring should be interpreted with care.
随着Bilitec 2000设备的引入，腔内胆汁监测已成为评估胃食管反流病和胆汁反流症状患者的标准技术。需要一种排除有色食物的特定“白色饮食”来提供准确的测量结果。这种特定饮食对同步食管pH监测的影响尚不清楚。对40例有反流症状的患者进行了前瞻性研究。使用患者方案以标准化方式记录进餐时间以及测量的仰卧位和直立位阶段。第1天开始采用“无色”饮食（水、牛奶、土豆、鱼、鸡肉）进行食管24小时pH监测，第2天摄入正常饮食后进行食管24小时pH测定。比较连续两次pH测量的数据。与无色饮食相比，正常饮食期间病理性食管pH测定的患病率显著更高（P = 0.025）。在总阶段和直立位阶段，采用白色饮食导致pH小于4的时间百分比显著降低（P≤0.01）、反流发作总数显著降低（P≤0.001）以及DeMeester评分显著降低（P = 0.01）。这种差异仅在pH测定正常的患者（第1组，n = 13）和病理性直立反流患者（第2组，n = 12）中发现。在单纯仰卧位反流患者（第3组，n = 7）和直立位与仰卧位联合反流患者（第4组，n = 8）中未发现反流模式有变化。在有病理性直立反流模式的患者中，采用白色饮食会导致食管pH测定有显著改变。来自同步食管pH和胆汁监测的数据应谨慎解释。
