Esophageal 24-Hour pH-Metry after Esophageal Manometry Facilitated by a New Medical Device, A Mini-Overtube

Esophageal manometry (EM) and ambulatory 24-hour esophageal pH-metry (EP) are techniques employed in the management of patients with gastroesophageal reflux disease (GERD). For these examinations, two consecutive probes must be placed nasally. To evaluate the introduction-time (IT) and patient tolerance (PT) during introduction of the EP probe after EM with and without the assistance of a new medical device, a mini-overtube (MOT). A series of 115 patients referred to our Gastroenterology Unit to undergo EM and EP were divided into two groups: group 1 underwent EM and EP by the traditional procedure, group 2 with the MOT. The mean IT for the EP probe was significantly shorter in group 2 than group 1 (7.4 ± 2.0 sec vs. 93.2 ± 57.1 sec; p<0.01). In group 1 no patients reported excellent tolerance to introduction of the EP probe, 22.7% reported good tolerance, 50% medium and 29.3% bad. In group 2, 61.4% reported excellent tolerance, 33.3% good, 5.3% medium and none bad. Six group 1 patients (10.3%) refused the introduction of the EP probe after 239.7 ± 113.9 seconds of unsuccessful efforts.This device facilitates the introduction of the EP probe in all patients, even those who would not otherwise agree to a second attempt.