J Neurogastroenterol Motil.
2025 Jan;31(1):63-74. 10.5056/jnm24051.
Baseline Impedance via Manometry Predicts Pathological Mean Nocturnal Baseline Impedance in Isolated Laryngopharyngeal Reflux Symptoms
- Affiliations
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- 1Division of Gastroenterology, Taichung Veterans General Hospital, Taichung, Taiwan
- 2Department of Otolaryngology, Taichung Veterans General Hospital, Taichung, Taiwan
- 3School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
- 4School of SpeechLanguage Pathology & Audiology, Chung Shan Medical University, Taichung, Taiwan
- 5School of SpeechLanguage Pathology & Audiology, Chung Shan Medical University, Taichung, Taiwan
- 6School of Medicine, Chung Shan Medical University, Taichung, Taiwan
- 7Department of Otolaryngology-Head and Neck Surgery, China Medical University Hospital, Taichung, Taiwan
- 8Division of Gastroenterology and Hepatology, Department of Internal Medicine, Tongs' Taichung MetroHarbor Hospital, Taichung, Taiwan
- 9Department of Post-Baccalaureate Medicine, College of Medicine, National Chung Hsing University, Taichung, Taiwan
- KMID: 2564645
- DOI: http://doi.org/10.5056/jnm24051
Abstract
- Background/Aims
Distal mean nocturnal baseline impedance (MNBI) measuring via pH-impedance may be valuable in diagnosing patients with suspected laryngopharyngeal reflux (LPR). However, its wide adoption is hindered by cost and invasiveness. This study investigates whether baseline impedance measured during high-resolution impedance manometry (HRIM-BI) can predict pathological MNBI.
Methods
A cross-sectional study in Taiwan included 74 subjects suspected of LPR, who underwent HRIM (MMS) and pH-impedance testing (Diversatek), after stopping proton pump inhibitors for more than 7 days. Subjects with grade C or D esophagitis or Barrett’s esophagus were excluded. The cohort was divided into 2 groups: those with concomitant typical reflux symptoms (CTRS, n = 28) and those with isolated LPR symptoms (ILPRS, n = 46). HRIM-BI measurements focused on both distal and proximal esophagi. Pathological MNBI was identified as values below 2065 Ω, measured 3 cm above the lower esophageal sphincter.
Results
In all subjects, distal HRIM-BI values correlated weakly with distal MNBI(r = 0.34-0.39, P < 0.005). However, in patients with ILPRS, distal HRIM-BI corelated moderately with distal MNBI(r = 0.43-0.48, P < 0.005). The areas under the receiver operating characteristic curve was 0.78 (P = 0.001) with a sensitivity of 0.83 and a specificity of 0.68. No correlation exists between distal HRIM-BI and distal MNBI in patients with CTRS, and between proximal HRIM-BI and proximal MNBI in both groups.
Conclusions
Distal HRIM-BI from HRIM may potentially predict pathological MNBI in patients with ILPRS, but not in those with CTRS. Future outcome studies linked to the metric are warranted.
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