Intraesophageal pH monitoring after breakfast + lunch in gastroesophageal reflux.

To evaluate intraesophageal pH monitoring during two consecutive 3-h postprandial periods (breakfast + lunch) in the diagnosis of pathological gastroesophageal reflux, we studied 40 patients with documented gastroesophageal reflux and 15 healthy controls. Reflux events were analyzed in the two separate postprandial periods, their sum (double postprandial pHmetry), and a standard 24-h period. Data from all pH-recording periods were compared and correlation coefficients were obtained between postprandial and 24-h reflux events. While pH recordings from the two separate postprandial periods provided good separation between patients and controls, double postprandial pHmetry was most accurate in the diagnosis of gastroesophageal reflux. In the latter procedure, mean percent reflux time was 2.5 +/- 1.8% in controls and 19.4% +/- 10.3% in patients (p less than 0.001), with a specificity of 100% and a sensitivity of 97%. A high degree of correlation existed for all reflux events between postprandial and 24-h pHmetries. We believe that double postprandial intraesophageal pH monitoring accurately distinguishes between normal persons and patients with pathological reflux. The technique considerably shortens the examination time in relation to 24-h pH monitoring and may prove the esophageal test of choice for objective evidence of gastroesophageal reflux.