A 30-year review and outlook on esophageal acid and pressure measurement_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

JIANG Yong , FANG Wentao , LI Zhigang , CHEN Wenhu , PAN Weihao , ZHENG Yanfang , ZHANG Hong , SU Yuchen ,  ZHANG Jie

Department of Thoracic Surgery, Shanghai Chest Hospital, Shanghai, 200025, P. R. China;

Corresponding author：

ZHANG Jie, Email: zhangjie2289@hotmail.com

Keywords：

Esophageal function; acid and pressure measurement; Bravo capsules; review

DOI：

10.7507/1007-4848.202312063

Video：

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The Department of Thoracic Surgery of Shanghai Chest Hospital has performed esophageal function testing for over 30 years, being the only department of its kind in China with this capability. The pressure testing and 24-hour pH/impedance monitoring of the esophagus is of great help to assist in the diagnosis and treatment of benign and malignant esophageal diseases related to it. Thanks to the esophageal function test, in addition to the routine various endoscopic anti-reflux procedures, our hospital has taken the lead in China in recent years to carry out a series of clinical and research work for benign esophageal diseases, such as the development of magnetic ring, double nedoscopic combination and new anti-reflux endoscopic techniques. In recent years, we have carried out high-resolution esophageal manometry and 24-hour pH/impedance monitoring for patients with interstitial pneumonia and pulmonary fibrosis suspected to be caused by gastroesophageal acid reflux. We can better assess the correlation between gastroesophageal reflux and pulmonary fibrosis, and to provide the different clinical treatments and even surgical interventions. The Bravo capsule is used more often in the United States, and it has obvious advantages over traditional approach for acid measurement. We strongly call for the collaboration between industry and academic institutions in this field, and the development of our own related products with independent intellectual property rights.

Citation： JIANG Yong, FANG Wentao, LI Zhigang, CHEN Wenhu, PAN Weihao, ZHENG Yanfang, ZHANG Hong, SU Yuchen, ZHANG Jie. A 30-year review and outlook on esophageal acid and pressure measurement. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2025, 32(6): 766-770. doi: 10.7507/1007-4848.202312063 Copy

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2.	陈文虎, 蒋勇, 周允中. 19例贲门癌术后食管腔内24小时pH监测结果分析. 中华胸心血管外科杂志, 1998, 1: 20-22.Chen WH, Jiang Y, Zhou YZ. The role of continuous 24-hour esophageal pH monitoring in evaluation of gastroesophageal reflux after esophagectomy for cardiac cancer. Chin J Thorac Cardiovasc Surg, 1998, 1: 20-22.
3.	陈文虎, 周允中, 黄偶麟, 等. 贲门失弛缓症218例手术结果分析. 医学研究通讯, 1997, 5: 42-44.Chen WH, Zhou YZ, Huang OL. Analysis of surgical outcomes in 218 patients with achalasia. J Med Res, 1997, 5: 42-44.
4.	Ganz RA, Gostout CJ, Gruden J, et al. Use of a magnetic sphincter for the treatment of GERD: A feasibility study. Gastrointest Endosc, 2008, 67(2): 287-294.
5.	Saino G, Bonavina L, Lipham JC, et al. Magnetic sphincter augmentation for gastroesophageal reflux at 5 years: Final results of a pilot study show long-term acid reduction and symptom improvement. J Laparoendosc Adv Surg Tech, 2015, 25(10): 787-792.
6.	Lipham JC, Tgignides PA, Louie BE, et al. Safety analysis of first 1000 patients treated with magnetic sphincter augmentation for gastroesophageal reflux disease. Dis Esophagus, 2015, 28(4): 305-311.
7.	Asti E, Siboni S, Lazzari V, et al. Removal of the magnetic sphincter augmentation device: Surgical technique and results of a single-center cohort study. Ann Surg, 2017, 265(5): 941-945.
8.	Vakil M, van Zanten SV, Kahrilas P, et al. The Montreal definition and classification of gastroesophgeal reflux disease: A global evidence-based consensus. Am J Gastroenterol, 2006, 101: 1900-1920.
9.	Peery AF, Dellon ES, Lund J, et al. Burden of gastrointestinal disease in the United States: 2012 update. Gastroenterology, 2012, 143(5): 1179-1187.
10.	El-Serag HB, Sweet S, Winchester CC, et al. Update on the epidemiology of gastro-oesophageal reflux disease: A systematic review. Gut, 2014, 63(6): 871-880.
11.	Becher A, El-Serag H. Systematic review: The association between symptomatic response to proton pump inhibitors and health-related quality of life in patients with gastro-oesophageal reflux disease. Aliment Pharmacol Ther, 2011, 34: 618-627.
12.	Gerson LB, Fass R. A systematic review of the definitions, prevalence, and response to treatment of nocturnal gastroesophageal reflux disease. Clin Gastroenterol Hepatol, 2009, 7: 372-378.
13.	Freedberg DE, Kim LS, Yang YX. The risks and benefits of long-term use of proton pump inhibitors: Expert review and best practice advice from the American Gastroenterological Association. Gastroenterology, 2017, 152(4): 706-715.
14.	Fu S, Xu M, Zhou H, et al. Metabolic syndrome is associated with higher rate of gastroesophageal reflux disease: A meta-analysis. Neurogastroenterol Motil, 2022, 34(5): e14234.
15.	Raghu G, Remy-Jardin M, Richeldi L, et al. Idiopathic pulmonary fibrosis (an update) and progressive pulmonary fibrosis in adults: An official ATS/ERS/JRS/ALAT clinical practice guideline. Am J Respir Crit Care Med, 2022, 205(9): e18-e47.
16.	Pandolfino JE, Richter JE, Ours T, et al. Ambulatory esophageal pH monitoring using a wireless system. Am J Gastroenterol, 2003, 98(4): 740-749.
17.	Streets CG, DeMeester TR, Peters JH, et al. Clinical evaluation of Bravo™ probe: A catheter-free ambulatory esophageal pH monitoring system. Gastroenterology, 2001, 120(5 Suppl 1): A35.
18.	Belafsky PC, Allen K, Castro-Del Rosario L, et al. Wireless pH testing as an adjunct to unsedated transnasal esophagoscopy: The safety and efficacy of transnasal telemetry capsule placement. Otolaryngol Head Neck Surg, 2004, 131(1): 26-28.
19.	Marchese M, Spada C, Iacopini F, et al. Nonendoscopic transnasal placement of a wireless capsule for esophageal pH monitoring: Feasibility, safety, and efficacy of a manometry-guided procedure. Endoscopy, 2006, 38(8): 813-818.
20.	Ward EM, Devault KR, Bouras EP, et al. Successful oesophageal pH monitoring with a catheter-free system. Aliment Pharmacol Ther, 2004, 19: 449-454.

1. 陈文虎, 方文涛, 蒋勇, 等. 贲门失弛症患者手术前后食管功能分析. 中华外科杂志, 1999, 37(2): 15-16.Chen WH, Fang WT, Jiang Y. Evaluation of pre- and post-operational esophageal manometric findings with achalasia. Chin J Surg, 1999, 37(2): 15-16.
2. 陈文虎, 蒋勇, 周允中. 19例贲门癌术后食管腔内24小时pH监测结果分析. 中华胸心血管外科杂志, 1998, 1: 20-22.Chen WH, Jiang Y, Zhou YZ. The role of continuous 24-hour esophageal pH monitoring in evaluation of gastroesophageal reflux after esophagectomy for cardiac cancer. Chin J Thorac Cardiovasc Surg, 1998, 1: 20-22.
3. 陈文虎, 周允中, 黄偶麟, 等. 贲门失弛缓症218例手术结果分析. 医学研究通讯, 1997, 5: 42-44.Chen WH, Zhou YZ, Huang OL. Analysis of surgical outcomes in 218 patients with achalasia. J Med Res, 1997, 5: 42-44.
4. Ganz RA, Gostout CJ, Gruden J, et al. Use of a magnetic sphincter for the treatment of GERD: A feasibility study. Gastrointest Endosc, 2008, 67(2): 287-294.
5. Saino G, Bonavina L, Lipham JC, et al. Magnetic sphincter augmentation for gastroesophageal reflux at 5 years: Final results of a pilot study show long-term acid reduction and symptom improvement. J Laparoendosc Adv Surg Tech, 2015, 25(10): 787-792.
6. Lipham JC, Tgignides PA, Louie BE, et al. Safety analysis of first 1000 patients treated with magnetic sphincter augmentation for gastroesophageal reflux disease. Dis Esophagus, 2015, 28(4): 305-311.
7. Asti E, Siboni S, Lazzari V, et al. Removal of the magnetic sphincter augmentation device: Surgical technique and results of a single-center cohort study. Ann Surg, 2017, 265(5): 941-945.
8. Vakil M, van Zanten SV, Kahrilas P, et al. The Montreal definition and classification of gastroesophgeal reflux disease: A global evidence-based consensus. Am J Gastroenterol, 2006, 101: 1900-1920.
9. Peery AF, Dellon ES, Lund J, et al. Burden of gastrointestinal disease in the United States: 2012 update. Gastroenterology, 2012, 143(5): 1179-1187.
10. El-Serag HB, Sweet S, Winchester CC, et al. Update on the epidemiology of gastro-oesophageal reflux disease: A systematic review. Gut, 2014, 63(6): 871-880.
11. Becher A, El-Serag H. Systematic review: The association between symptomatic response to proton pump inhibitors and health-related quality of life in patients with gastro-oesophageal reflux disease. Aliment Pharmacol Ther, 2011, 34: 618-627.
12. Gerson LB, Fass R. A systematic review of the definitions, prevalence, and response to treatment of nocturnal gastroesophageal reflux disease. Clin Gastroenterol Hepatol, 2009, 7: 372-378.
13. Freedberg DE, Kim LS, Yang YX. The risks and benefits of long-term use of proton pump inhibitors: Expert review and best practice advice from the American Gastroenterological Association. Gastroenterology, 2017, 152(4): 706-715.
14. Fu S, Xu M, Zhou H, et al. Metabolic syndrome is associated with higher rate of gastroesophageal reflux disease: A meta-analysis. Neurogastroenterol Motil, 2022, 34(5): e14234.
15. Raghu G, Remy-Jardin M, Richeldi L, et al. Idiopathic pulmonary fibrosis (an update) and progressive pulmonary fibrosis in adults: An official ATS/ERS/JRS/ALAT clinical practice guideline. Am J Respir Crit Care Med, 2022, 205(9): e18-e47.
16. Pandolfino JE, Richter JE, Ours T, et al. Ambulatory esophageal pH monitoring using a wireless system. Am J Gastroenterol, 2003, 98(4): 740-749.
17. Streets CG, DeMeester TR, Peters JH, et al. Clinical evaluation of Bravo™ probe: A catheter-free ambulatory esophageal pH monitoring system. Gastroenterology, 2001, 120(5 Suppl 1): A35.
18. Belafsky PC, Allen K, Castro-Del Rosario L, et al. Wireless pH testing as an adjunct to unsedated transnasal esophagoscopy: The safety and efficacy of transnasal telemetry capsule placement. Otolaryngol Head Neck Surg, 2004, 131(1): 26-28.
19. Marchese M, Spada C, Iacopini F, et al. Nonendoscopic transnasal placement of a wireless capsule for esophageal pH monitoring: Feasibility, safety, and efficacy of a manometry-guided procedure. Endoscopy, 2006, 38(8): 813-818.
20. Ward EM, Devault KR, Bouras EP, et al. Successful oesophageal pH monitoring with a catheter-free system. Aliment Pharmacol Ther, 2004, 19: 449-454.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

A 30-year review and outlook on esophageal acid and pressure measurement

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