The comparison of 24 hour ph-impedance monitorization of manual and automatic analyzes in patients with gastroesophageal reflux desease off and on proton pump inhibitor theraphy

24-hour intraosophageal ambulatory impedance-pH meter; is an important diagnostic tool in gastroesophageal reflux disease. Many researchers reach a diagnosis with automatic analysis because manual analysis takes a long time. In this study, number of reflux events (acid-non acid-weak acid), reflux contents (liquid-mix), bolus clearance times, LES ≥ 15 cm reflux events were compared and assessed whether there was a significant difference. In addition, the activities of manual and automatic analyzes were determined separately for patients before and after PPI treatment. This has helped us to predict whether manual analysis is necessary in pre- and post-PPI patients in clinical practice. To the best of our knowledge, a similar study in the international literature has only been done with the results of different patients who were previously under PPI treatment or not undergoing PPI treatment. A similar study is not in the literature before and after PPI treatment in the same patients. Also; PPI response rates of patients were compared before and after PPI treatment in manual analyzes and it was assessed whether there was a significant relationship between treatment response and changes in reflux, acid reflux, weakly acid reflux, and LES ≥ 15 cm reflux events after treatment. In our study, on-off PPI patients were analysed in harmony with manual and automatic analyzes using various parameters and Blant Altman graphs were used in manual automatic analysis in on-off PPI patients. The nonparametric Brunner - Langer model was also supported by the effects of off and on PPI treatment, the effect of manual and automated analyzes, and the interaction of these factors with relative interaction graphs. Gender variables have also been added to these data, but no significant interaction has been detected. In addition, in the manual analyzes, the interaction between the nonparametric Brunner - Langer model and the variables in the PPI - responsive and unresponsive group and the variables before and after the PPI treatment were examined. These data are supported by relative interaction graphs. In the obtained data light; in patients who have atypical reflux symptoms (patients with extra-esophageal findings), patients with weakly acid reflux dominant reflux, and patients with relatively high reflux events should be analyzed manually. In this way it may be possible to avoid misdiagnosis in analyzes. In addition, automated assays can be relied on in patients with predominantly acidic reflux. In assessing response to proton pump inhibitor treatment; number of reflux, number of acid reflux and LES ≥ 15 cm reflux events in patients with and without treatment response dropped in a similar manner; it should be kept in mind that the number of weakly acidic reflux events increases more in patients with treatment response.