Morning placement of 48-hour wireless capsule results in less reflux
Afternoon placement of the 48-hour wireless ambulatory pH capsule has significantly increased the amount of acid reflux on the first day, a recent study has found.
“Approximately 10 percent of the 48-hour oesophageal wireless monitoring studies may falsely overestimate reflux when the capsule is placed in the afternoon,” researchers said.
A retrospective cohort study was conducted to investigate the differences in data obtained on day 1 vs day 2, and the effect of time of capsule placement on discrepancies. Included were patients (n=229) undergoing a 48-hour wireless capsule study between January 2012 through November 2013.
Researchers collected reflux data for each patient and calculated the proportion of patients in four groups based on abnormal DeMeester score groups (+/+, −/+, +/−, −/−). Participants were assigned to morning or afternoon placement categories, and the proportions of patients with different DeMeester score discrepancies were calculated.
The mean DeMeester scores were 28.38 for day 1 and 23.24 for day 2 (p<0.0001). For day 1, the mean DeMeester score in the morning group was 24.9 and in the afternoon group 31.7 (p<0.05). The mean total DeMeester scores in the morning and afternoon placement groups were 23.1 and 30.6, respectively (p<0.05).
A +day 1/−day 2 DeMeester discordance was observed in 25 percent of afternoon patients, while such discordance was seen in only 12 percent of morning placement patients (p=0.26).
These findings suggest that placement of 48-hour wireless capsules should ideally be performed in the morning, according to researchers.
“A 48-hour wireless capsule results often vary from the first to second day. Previous investigations comparing discrepant acid reflux readings have yielded variable results,” researchers noted.