The Effect of Type of Sedation or Lack of It on Wireless Esophageal pH Capsule Test Results.

Abstract

Introduction: Wireless esophageal pH monitoring is used to diagnose gastroesophageal reflux disease in patients with heartburn. Current studies are conflicting on the effect of sedation on acid reflux. The aim of our study was to determine if the type of sedation used during endoscopy or lack of it affects the first day of esophageal acid exposure results as compared to the second day.

Methods: Consecutive patients who underwent a 48-h or 96-h wireless pH capsule study to assess heartburn symptoms were included. Those who underwent the study under monitored anesthesia care (MAC), moderate sedation, and no sedation were compared. The recorded esophageal acid exposure time during Day 1 was compared to Day 2.

Results: Overall, there was no statistical difference in overall wireless pH capsule results in those undergoing testing sedated versus unsedated. There was also no difference between Days 1 and 2 of percent total time pH < 4 during MAC sedation (p = 0.89), moderate sedation (p = 0.22), and no sedation (p = 0.89). However, there was a statistically significant difference in time pH < 4 on Day 1 versus Day 2 during supine position in those with MAC and moderate sedation (p = 0.04 for both).

Conclusions: We demonstrated that the percent total time pH < 4 during the first day of a wireless pH capsule test was similar to Day 2. Our study also demonstrates that neither type of sedation nor lack of it has a significant impact on the results of the BRAVO test on Day 1 versus Day 2 or on overall results.