MII to characterize reflux in Barrett's esophagus

描述（由申请人提供）：本研究将检验Barrett食管（BE）患者与无BE的单纯GERD患者和正常志愿者相比，其食管功能缺损更严重，胃食管反流（GER）更多的假设。这将使用最近开发的多通道腔内阻抗（MII）技术来完成，这是一种更灵敏的食管功能测试，也是评估所有类型（酸型和非酸型）GER的手段。结合一种特殊的导管，MII与腔内压力传感器相结合，提供了一种更灵敏的食管功能测试，包括在没有辐射暴露的情况下测量大剂量输送的能力。同样，一种特殊的导管，其中pH敏感电极与MII相结合，提供了一种灵敏的技术来识别所有形式的GER，而不依赖于pH。我们将前瞻性地研究20例BE患者、20例无并发症的GER患者（患者对照组）和20名健康志愿者（正常对照组）的食管功能和GER的特征。基线评估后，所有参与者将接受质子泵抑制剂（埃索美拉唑40mg）治疗，每天两次，持续8周。在完成8周的强化治疗后，每位患者将在继续抑酸方案的同时进行食管功能的重复研究。这些研究将确定抑制胃酸对BE患者是否与非复杂性胃反流患者和正常志愿者一样有效，包括评估胃酸水平和持续反流的证据，包括酸和非酸成分。预计本提案中概述的研究将更好地阐明BE患者发生的食管功能异常，这些异常可能导致更严重的胃食管反流病。

DESCRIPTION (provided by applicant): This study will test the hypothesis that patients with Barrett's esophagus (BE) have a more severe defect in esophageal function and more gastroesophageal reflux (GER) compared to patients with uncomplicated GERD without BE and normal volunteers. This will be accomplished using a recently developed technology of multichannel intraluminal impedance (MII) as a more sensitive test of esophageal function and as a means of assessing GER of all types (acid and non-acid). Incorporating a special catheter, MII combined with intraluminal pressure transducers provides a more sensitive test of esophageal function, including the ability to measure bolus transit without radiation exposure. Likewise, a special catheter in which pH sensitive electrodes are combined with MII provides a sensitive technique to identify all forms of GER, independent of pH. We will prospectively study esophageal function and characteristics of GER in 20 patients with BE, 20 patients with uncomplicated GER (patient controls) and 20 healthy volunteers (normal controls). Following a baseline assessment, all participants will be treated with a proton pump inhibitor (esomeprazole 40mg) taken twice daily for a period of 8 weeks. Upon completion of 8 weeks of intensive therapy, each patient will have repeated studies of esophageal function while continuing on the acid suppressing regimen. These studies will identify whether acid suppression is as effective in patients with BE as in those with uncomplicated GERD and normal volunteers, including assessment of the level of intragastric acidity and evidence of persistent reflux, both the acid and non-acid component. It is anticipated that the studies outlined in this proposal will provide better clarification of the esophageal functional abnormalities occurring in patients with BE that permit a more aggressive form of gastroesophageal reflux disease.