Normal values and day‐to‐day variability of 24‐h ambulatory oesophageal impedance‐pH monitoring in a Belgian–French cohort of healthy subjects

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Abstract
Summary: Background : Impedance‐pH monitoring is the most sensitive method for detection and characterization of gastro‐oesophageal reflux episodes. Normal values from European subjects are lacking.Aim : To build a database of gastro‐oesophageal reflux patterns from French and Belgian healthy subjects.Methods : Seventy‐two healthy subjects (35 men, mean age 35 years, 18–72) underwent 24‐h ambulatory impedance‐pH studies. Gastro‐oesophageal reflux episodes were detected using impedance and characterized by pH as acid, weakly acidic, or weakly alkaline. Analysis was performed visually and effects of age, gender and intra‐individual reproducibility were evaluated.Results : The total number of gastro‐oesophageal reflux episodes was 44 (25,58,75) of which 59% were acid, 28% were weakly acidic and 10% weakly alkaline. Half of gastro‐oesophageal reflux episodes were mixed (liquid/gas) and 22% reached 15 cm above the lower oesophageal sphincter. The bolus clearance time was 11 s while acid was chemically cleared in 34 s. Male gender was associated with increased number and proximal extent of total and acid gastro‐oesophageal reflux. Repeated studies in 27 subjects showed good reproducibility for number, acidity and air–liquid composition of reflux (Kendall's W‐values = 0.72–0.85).Conclusions : This study demonstrates good reproducibility of 24‐h ambulatory impedance‐pH studies and provides values of reflux patterns in healthy subjects for comparisons with European gastro‐oesophageal reflux disease patients.