Esophageal 24-Hour pH-Metry after Esophageal Manometry Facilitated by a New Medical Device, A Mini-Overtube

Benedetto Mangiavillano*, 1, Sandro Passaretti2, Maura Corsetti2, Gianni Mezzi2, Simona Curioni2, Pier Alberto Testoni2
1 Department of Gastrointestinal Endoscopy, University San Paolo Hospital, Milan, Italy
2 Physiopathology Digestive Laboratory, Gastroenterology and Gastrointestinal Endoscopy Unit, Vita-Salute San Raffaele University, Scientific Institute San Raffaele, Milan, Italy

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© 2009 Mangiavillano et al.;

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

* Address correspondence to this author at the Dept. of Gastrointestinal Endoscopy, San Paolo University Hospital, Via A. di Rudinì 8, 20142 Milan, Italy; Tel: 0039 02 8184-4273-4057; Fax: 0039 02 89125264; E-mail:


Esophageal manometry (EM) and ambulatory 24-hour esophageal pH-metry (EP) are techniques employed in the management of patients with gastroesophageal reflux disease (GERD). For these examinations, two consecutive probes must be placed nasally. To evaluate the introduction-time (IT) and patient tolerance (PT) during introduction of the EP probe after EM with and without the assistance of a new medical device, a mini-overtube (MOT). A series of 115 patients referred to our Gastroenterology Unit to undergo EM and EP were divided into two groups: group 1 underwent EM and EP by the traditional procedure, group 2 with the MOT. The mean IT for the EP probe was significantly shorter in group 2 than group 1 (7.4 ± 2.0 sec vs. 93.2 ± 57.1 sec; p<0.01). In group 1 no patients reported excellent tolerance to introduction of the EP probe, 22.7% reported good tolerance, 50% medium and 29.3% bad. In group 2, 61.4% reported excellent tolerance, 33.3% good, 5.3% medium and none bad. Six group 1 patients (10.3%) refused the introduction of the EP probe after 239.7 ± 113.9 seconds of unsuccessful efforts.This device facilitates the introduction of the EP probe in all patients, even those who would not otherwise agree to a second attempt.