LPR ph studies: dual CHANNEL vs dual PROBE

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drtinsac
Regular Member


Date Joined Apr 2012
Total Posts : 458
   Posted 6/5/2012 9:55 AM (GMT -6)   
Hopefully someone knows this or can point out a link that explains this..

I had a test for GERD which from my test results is described as "dual channel" ph probe. It provided the # of reflux events, and whether they were acidic, non acidic, or weakly acidic. From my basic knowledge, I think the "channels" are PH and impedance? When I was wearing this device, I could look into my mouth at the probe cable, and I'm fairly sure I saw a "sensor" towards the back of my throat.

Yet there is another test, for LPR, where they refer to it as "dual probe" and they say that one of the probes should go in the larynx area. When they call it dual probe it certainly sounds like there are 2 cables, or maybe 1 cable with 2 branches. Yet, the "dual channel" study had a sensor in my throat. So what is different about the "dual probe" study that makes it better for picking up LPR?

Is either of those tests the MII test, or is that a completely different probe?

I almost need to read a textbook about this. I forgot to ask last time I was at the doc and don't have an appointment scheduled yet for my next visit.

Thanks for any insights.

dencha
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Date Joined Feb 2009
Total Posts : 7180
   Posted 6/5/2012 7:45 PM (GMT -6)   
Hi drtinsac,
I don't think "dual probe" means two wires.  It just means that it measures reflux in two places..one at the traditionally low GERD diagnosis location, and one higher up, so that it can monitor what reflux makes it that high.
 
Here is a Wikipedia quote that might be helpful:
pH monitoring in laryngopharyngeal reflux

Retrograde flow of gastric contents to the upper aerodigestive tract causes a variety of symptoms such as cough, asthma and hoarseness. These respiratory manifestations of the reflux disease commonly called laryngopharyngeal reflux (LPR) or extraesophegeal reflux disease (EERD). Distal esophageal pH monitoring has been used as an objective test to establish reflux as the cause of the atypical reflux symptoms but, its role in causally associating patients’ symptoms to GERD is controversial. In an effort to improve diagnostic accuracy of testing, a catheter with two pH senors has been used to measure the degree of esophageal acid exposure in both distal and proximal esophagus. The ideal location for pH measurement to confirm the diagnosis of the laryngopharyngeal reflux is pharynx and new studies has focused on the development of a new pH sensor which can function in the challenging environment of the oropharynx[8].

Wikipedia link:http://en.wikipedia.org/wiki/Esophageal_pH_monitoring

Here's a short abstract regarding a study of the value of using dual probe monitoring in diagnosing LPR symptoms.
 
Hope this information is helpful.  I know it's hard to navigate the information.  They need to write a "GERD for Dummies" book, don't you think?
 
Best wishes in your quest!
Denise turn
Words of wisdom by Eckhart Tolle:
"Whatever you fight, you strengthen, and what you resist, persists.”

“Worry pretends to be necessary but serves no useful purpose”

“Accept - then act. Whatever the present moment contains, accept it as if you had chosen it. Always work with it, not against it.”

drtinsac
Regular Member


Date Joined Apr 2012
Total Posts : 458
   Posted 6/6/2012 6:12 AM (GMT -6)   
Denise - thank you for the links and information, and I agree it's a ton of information to try to sift through. I still think there may be 2 wires involved in certain dual sensor tests, because I have read that it's critical where the sensors are placed. One has to be 5 cm above the LES and the other is placed in some specific distance from the UES. If there was only a single wire with probes placed along it, the sensors would not be in the right places from person to person. If this is true maybe I've answered my own question about why a single "probe" even with "dual channels" where the distal sensor is placed 5 cm above the LES, regardless of where the other sensors happen to fall, does not provide much information for LPR -- OR perhaps, since the focus of the test is the 5cm above LES location, the person who summarized my test results didn't evaluate what was going on in the sensors near my throat.

I'll check with the specialist for sure next time and will plan to come back here with any nuggets of clarification.

JPT - I think that's accurate. Another thing I've read is that any of these probe tests may not pick up small amounts that work their way up, and these small amounts over time can cause some real LPR problems.
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