An Implantable, Batteryless, and Wireless Capsule With Integrated Impedance and pH Sensors for Gastroesophageal Reflux Monitoring

CONTEXT: Gastroesophageal reflux disease is one of the most common digestive diseases and an important cause of distress to patients. Diagnosis of this condition can require ambulatory pH monitoring. OBJECTIVES: To determine the diagnostic yield of a wireless ambulatory pH monitoring system of 48-hours, recording to diagnose daily variability of abnormal esophageal acid exposure and its symptom association. METHODS: A total of 100 consecutive patients with persistent reflux symptoms underwent wireless pH capsule placement from 2004 to 2009. The wireless pH capsule was deployed 5 cm proximal to the squamocolumnar junction after lower esophageal sphincter was manometrically determined. The pH recordings over 48-h were obtained after uploading data to a computer from the receiver that recorded pH signals from the wireless pH capsule. The following parameters were analyzed: (1) percentual time of distal esophageal acid exposure; (2) symptom association probability related to acid reflux. The results between the first and the second day were compared, and the diagnostic yield reached when the second day monitoring was included. RESULTS: Successful pH data over 48-h was obtained in 95% of patients. Nearly one quarter of patients experienced symptoms ranging from a foreign body sensation to chest pain. Forty-eight hours pH data analysis was statistically significant when compared to isolated analysis of day 1 and day 2. Study on day 2 identified seven patients (30.4%) that would be missed if only day 1 was analyzed. Three patients (18.7%) out of 16 patients with normal esophageal acid exposure on both days, showed positive symptom association probability, which generated an increase in diagnostic yield of 43.4%. CONCLUSION: Esophageal pH monitoring with wireless capsule is safe, well tolerated, does not require sedation. The extended 48-h period of study poses an increased yield to diagnose gastroesophageal reflux disease patients.

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Nanofabricated Sensing Electrodes in a Batteryless Endoluminal Sensing Telemeter for Diagnosis of Gastroesophageal Reflux Disease (GERD)

ASME 2010 First Global Congress on NanoEngineering for Medicine and Biology ◽

10.1115/nemb2010-13313 ◽

2010 ◽

Author(s):

Lun-Chen Hsu ◽

Wen-Ding Huang ◽

Shou-Jiang Tang ◽

Stuart Spechler ◽

H. F. Tibbals ◽

...

Keyword(s):

Gastroesophageal Reflux Disease ◽

Gastroesophageal Reflux ◽

Reflux Disease ◽

Sensor Data ◽

Ph Sensing ◽

Impedance Sensing ◽

Ph Values ◽

Sensing System ◽

Dual Sensor ◽

Wireless Capsule

Gastroesophageal reflux disease (GERD) is recognized the primary risk factor associated with esophageal cancers. Therefore, monitoring GERD symptoms accurately is important for early diagnosis of such cancers. In this work, interdigitated impedance sensing electrodes and nanofabricated IrOx-based pH sensing electrodes were made on the flexible substrates that can be easily embedded into an implantable device. The dual sensor electrodes were integrated into a batteryless wireless capsule packaged with biocompatible material for implant applications. The proposed sensing system has been tested with stimulated solutions of different pH values recording modulated sensor data in terms of frequency shifts to verify its performance. The experimental results showed that the impedance electrodes responded to ion content variations and the pH electrodes identified the pH values of various pH solutions. Our sensing system has demonstrated the ability to detect gastroesophageal reflux activities more accurately, which could help doctors to provide precise treatment methods, consequentially lowering the risks of esophageal cancer development.

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Gastroesophageal Reflux Disease: Serious Illness Potential Often Misunderstood

ASHA Leader ◽

10.1044/leader.ftr1.11152006.6 ◽

2006 ◽

Vol 11 (15) ◽

pp. 6-21

Author(s):

Ellen N. Friedman

Keyword(s):

Gastroesophageal Reflux Disease ◽

Gastroesophageal Reflux ◽

Reflux Disease ◽

Serious Illness

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Gastroesophageal Reflux Disease: A Gastroenterologist's Perspective

Perspectives on Voice and Voice Disorders ◽

10.1044/vvd21.3.89 ◽

2011 ◽

Vol 21 (3) ◽

pp. 89-99

Author(s):

Michael F. Vaezi

Keyword(s):

Gastroesophageal Reflux Disease ◽

Gastroesophageal Reflux ◽

Reflux Disease ◽

Best Practice ◽

Clinical Care ◽

Diagnostic Testing ◽

Diagnostic Tools ◽

Swallowing Function ◽

Atypical Symptoms

Gastroesophageal reflux disease (GERD) is a commonly diagnosed condition often associated with the typical symptoms of heartburn and regurgitation, although it may present with atypical symptoms such as chest pain, hoarseness, chronic cough, and asthma. In most cases, the patient's reduced quality of life drives clinical care and diagnostic testing. Because of its widespread impact on voice and swallowing function as well as its social implications, it is important that speech-language pathologists (SLPs) understand the nature of GERD and its consequences. The purpose of this article is to summarize the nature of GERD and GERD-related complications such as GERD-related peptic stricture, Barrett's esophagus and adenocarcinoma, and laryngeal manifestations of GERD from a gastroenterologist's perspective. It is critical that SLPs who work with a multidisciplinary team understand terminology, diagnostic tools, and treatment to ensure best practice.

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