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Symptomatic gastro-oesophageal reflux in a patient with achlorhydria
  1. A J Bredenoord1,
  2. A Baron2,
  3. A J P M Smout2
  1. 1Department of Gastroenterology, Sint Antonius Hospital, Nieuwegein, the Netherlands
  2. 2Gastrointestinal Research Unit, Department of Gastroenterology, University Medical Centre, Utrecht, the Netherlands
  1. Correspondence to:
    Dr A J Bredenoord
    Department of Gastroenterology, St Antonius Hospital, PO Box 2500, 3430 EM Nieuwegein, the Netherlands; a.bredenoord{at}antonius.net

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Intraluminal impedance monitoring makes it possible to detect gastro-oesophageal reflux, independent of its pH.1 This is useful because other factors apart from acidity are important in symptom generation.2 Here, we describe a patient with achlorhydria in which impedance monitoring was used to identify gastro-oesophageal reflux as the cause of her symptoms.

A 72 year old female presented at our department. She complained of a retrosternal burning sensation which occurred at least five times a day. Eighteen months previously, her general practitioner prescribed monthly vitamin B12 injections after a routine blood test had revealed a megaloblastic macrocytic anaemia. She had underwent laparoscopic cholecystectomy for symptomatic gall stones four years previously.

Oesophageal manometry and 24 hour pH monitoring were performed. Results of oesophageal manometry were unremarkable. Ambulatory 24 …

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