MII to characterize reflux in Barrett's esophagus

描述(申请人提供)：这项研究将检验这样一种假设，即与无BE的无并发症的GERD患者和正常志愿者相比，Barrett食道(BE)患者有更严重的食道功能缺陷和更多的胃食道反流(GER)。这将使用最新开发的多通道管腔内阻抗(MII)技术来实现，作为一种更敏感的食道功能测试，并作为评估所有类型(酸性和非酸性)GER的手段。结合特殊的导管，MII结合腔内压力传感器提供了一种更灵敏的食道功能测试，包括在没有辐射暴露的情况下测量团注传输的能力。同样，一种将pH敏感电极与MII相结合的特殊导管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患者和20名健康志愿者的食道功能和GER的特点。在基线评估之后，所有参与者都将接受质子泵抑制剂(埃索美拉唑40 mg)的治疗，每天两次，为期8周。在完成8周的强化治疗后，每个患者都将进行重复的食道功能研究，同时继续进行抑酸治疗。这些研究将确定抑酸在BE患者中是否与那些无并发症的GERD患者和正常志愿者一样有效，包括评估胃内酸度水平和持续反流的证据，包括酸和非酸成分。预计这项建议中概述的研究将更好地澄清BE患者中发生的食道功能异常，这些异常可能导致更具侵袭性的胃食道反流病。

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.