Impedance–pH monitoring

Impedance–pH monitoring is a technique used in the diagnosis of gastroesophageal reflux disease, by monitoring both impedance and pH.^[1]^[2]

Patients with ongoing symptoms while on PPI therapy are commonly diagnosed with impedance–pH monitoring while continuing their medications. The impedance–pH monitoring diagnostic test determines the frequency of reflux episodes and the time relationship of reflux episodes and symptoms. The impedance–pH monitoring test determines if the patient's symptoms are related to acid reflux, related to nonacid reflux, or not related to reflux of any type. A positive GERD diagnosis is made if acid or nonacid reflux precedes symptoms in a statistically meaningful manner. Patients with a positive impedance–pH monitoring test may benefit from acid-reduction therapy such as fundoplication surgery or endoscopic fundoplication techniques.

References

↑ Pritchett JM, Aslam M, Slaughter JC, Ness RM, Garrett CG, Vaezi MF (March 2009). "Efficacy of Esophageal Impedance/pH Monitoring in Patients With Refractory Gastroesophageal Reflux Disease, on and off Therapy". Clin. Gastroenterol. Hepatol. 7 (7): 743–8. doi:10.1016/j.cgh.2009.02.022. PMID 19281866.
↑ C. j. Hawkey (2012). Textbook of Clinical Gastroenterology and Hepatology (2nd ed.). John Wiley & Sons. p. 186. ISBN 9781405191821.

Surgical procedures involving the digestive system (ICD-9-CM V3 42–54, ICD-10-PCS 0D)

Digestive tract

Upper GI tract

SGs / Esophagus	Esophagectomy Heller myotomy Sialography Impedance–pH monitoring Esophageal pH monitoring Esophageal motility study

Stomach	Bariatric surgery Adjustable gastric band Gastric bypass surgery Sleeve gastrectomy Vertical banded gastroplasty surgery Collis gastroplasty Gastrectomy Billroth I Billroth II Roux-en-Y Gastroenterostomy Gastropexy Gastrostomy Percutaneous endoscopic gastrostomy Hill repair Nissen fundoplication Pyloromyotomy

Medical imaging	Endoscopy: Esophagogastroduodenoscopy Barium swallow Upper gastrointestinal series

Lower GI tract

Small bowel	Bariatric surgery Duodenal switch Jejunoileal bypass Bowel resection Ileostomy Intestine transplantation Jejunostomy Partial ileal bypass surgery Strictureplasty

Large bowel	Appendicectomy Colectomy Colonic polypectomy Colostomy Hartmann's operation

Rectum	Abdominoperineal resection / Miles operation Lower anterior resection Total mesorectal excision

Anal canal	Anal sphincterotomy Anorectal manometry Lateral internal sphincterotomy Rubber band ligation Transanal hemorrhoidal dearterialization

Medical imaging	Endoscopy: Colonoscopy Anoscopy Capsule endoscopy Enteroscopy Proctoscopy Sigmoidoscopy Abdominal ultrasonography Defecography Double-contrast barium enema Endoanal ultrasound Enteroclysis Lower gastrointestinal series Small-bowel follow-through Transrectal ultrasonography Virtual colonoscopy

Stool tests	Fecal fat test Fecal pH test Stool guaiac test

Accessory

Liver	Artificial extracorporeal liver support Bioartificial liver devices Liver dialysis Hepatectomy Liver biopsy Liver transplantation Portal hypertension Transjugular intrahepatic portosystemic shunt [TIPS] Distal splenorenal shunt procedure

Gallbladder, bile duct	Cholecystectomy Cholecystostomy ERCP Hepatoportoenterostomy Medical imaging: Cholangiography IV MRCP PTC Cholecystography Cholescintigraphy

Pancreas	Frey's procedure Pancreas transplantation Pancreatectomy Pancreaticoduodenectomy Puestow procedure

Abdominopelvic

Peritoneum	Diagnostic peritoneal lavage Intraperitoneal injection Laparoscopy Omentopexy Paracentesis Peritoneal dialysis

Hernia	Hernia repair: Inguinal hernia surgery Femoral hernia repair

Other

CPRs

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