Hardware Monitoring of Acid-Dependent Conditions in Surgery for Gastroesophageal Reflux

Gastroesophageal reflux can significantly reduce the patient's quality of life and trigger a cascade of pathological changes in the mucous membrane of the esophagus. To study reflux, pH monitoring, pH impedance monitoring, and high resolution manometry are used. Daily pH-impedance monitoring can significantly expand diagnostic boundaries due to the possibility of differentiation of the pharynx, visualization of all types of refluxes, manual and computer analysis of cumulative pH and impedance curves. Correct selection of the probe and high-quality installation of the lower sensors relative to the lower esophageal sphincter helps to avoid overdiagnosis of gastric reflux and to get answers to the questions posed. A detailed analysis of manual and automatic indicators (acid exposure time, total refluxes, DeMeester score, esophageal mean nocturnal baseline impedance post-reflux swallow-induced peristaltic wave etc.) allows an independent conclusion and to predict the result of therapeutic or surgical treatment.