Dual focus NBI for the diagnosis of Non-Erosive Reflux Disease
Research type
Research Study
Full title
A prospective observational cohort study to assess the use of Dual Focus Narrow Band Imaging for the Endoscopic Diagnosis of Non-Erosive Reflux Disease
IRAS ID
227223
Contact name
Bu'Hussain Hayee
Contact email
Sponsor organisation
King's College Hospital NHS Foundation Trust
Duration of Study in the UK
1 years, 0 months, 0 days
Research summary
Gastro-oesophageal reflux disease (GORD) can present in different ways including heartburn, indigestion, nausea/vomiting and hoarse voice. It can also occasionally cause chest pain and recurrent chest infections and it is important to look for this in people experiencing such symptoms as it can then be treated. GORD is subcategorised into erosive reflux disease (ERD) which is readily identified during standard gastroscopy, non-erosive reflux disease (NERD) and functional heartburn (FH); the latter two that cannot be diagnosed using standard gastroscopy. Based on symptoms, it is unreliable distinguish between NERD and FH even with proton-pump inhibitor (PPI) challenge as PPI non-responsive GORD can account for this. Gastroscopy is required for patients experiencing the above symptoms. It is routine practice to take samples (biopsies) from the gullet (oesophagus) at the time of gastroscopy. Biopsies are a standard part of most endoscopy tests. Confirmation of NERD usually requires an additional test to identify excess acid exposure over 24-48 hours which requires an additional appointment.
A technique called dual focus narrow band imaging (NBI) uses specific light wavelengths highlighting blood vessel patterns making it much easier to see any abnormal areas. This technology is inbuilt in the gastroscopes and just requires a touch of a button to use. It is possible that this technology could mean that NERD could be diagnosed during the gastroscopy and not require biopsy at all.
We are testing whether the use of dual focus NBI can diagnose NERD without needing to take samples or requiring pH testing. This could potentially enable a diagnosis of NERD to be made directly at the time of gastroscopy meaning patients would not need additional tests. Additionally we will be assessing whether this imaging technique can be used accurately by endoscopy doctors of varied experience by reviewing patient anonymised video recordings after training in dual focus NBI.REC name
North West - Liverpool Central Research Ethics Committee
REC reference
17/NW/0562
Date of REC Opinion
12 Sep 2017
REC opinion
Favourable Opinion