Case 2
A 15-year-old patient with severe asthma was addressed to the reflux
clinic to exclude ear, nose and throat disorders that may worsen asthma.
The symptoms of the patient consisted of chronic cough, throat clearing
and globus sensation. The fiberoptic examination reported edema and
erythema of the posterior commissure. According to the clinical
findings, HEMII-pH was performed to exclude the LPR diagnosis. The
placement of the HEMII-pH catheter (Versaflex-Z®, Medtronic, Europe) and
the characteristics of the device were similar to those reported in the
first case. The patient had belching, nausea and several vomiting
episodes during the probe placement. During the 24-hour testing, the
patient reported many heartburn and belching episodes, which were not
reported in the initial clinical picture. The removal of the probe was
associated with nose pain and the physician found a folded probe (above
Z5 segment; Figure 3). Tracing revealed parasites in the distal
impedance segment throughout the 24-hour testing period. According to
the tracing, the probe was probably folded during the vomiting episodes
(placement time) and the related retrograde esophageal contraction. The
rest of the recording confirmed the nonacid LPR diagnosis. The patient
consent was obtained.