BACKGROUND: Heartburn and regurgitation are considered highly specific symptoms of gastroesophageal reflux. A considerable number of patients with these symptoms do not have endoscopic signs of esophagitis. AIM: To study the relationship between gastroesophageal reflux symptoms and 24 h esophageal pH mesurement in patients with normal or near normal endoscopic findings. PATIENTS AND METHODS: One hundred eighty six patients with persistent reflux symptoms and absence of severe endoscopic esophagitis were studied. Pathological studies of esophageal biopsies, manometry and 24 h esophageal pH measurements were performed in all. RESULTS: Abnormal acid reflux was found in 131 patients (70%). No differences in the frequency of symptoms, gender or pathologic findings were observed between patients with or without abnormal acid reflux. However, a higher frequency of esophageal erosions and a lower resting pressure of the inferior sphincter of the esophagus was observed in patients with abnormal acid reflux. CONCLUSIONS: Thirty percent of patients with heartburn and regurgtitation did not have abnormal acid reflux. Therefore, these symptoms are not specific for gastroesophageal reflux.
BACKGROUND: Heartburn and regurgitation are considered highly specific symptoms of gastroesophageal reflux. A considerable number of patients with these symptoms do not have endoscopic signs of esophagitis. AIM: To study the relationship between gastroesophageal reflux symptoms and 24 h esophageal pH mesurement in patients with normal or near normal endoscopic findings. PATIENTS AND METHODS: One hundred eighty six patients with persistent reflux symptoms and absence of severe endoscopic esophagitis were studied. Pathological studies of esophageal biopsies, manometry and 24 h esophageal pH measurements were performed in all. RESULTS: Abnormal acid reflux was found in 131 patients (70%). No differences in the frequency of symptoms, gender or pathologic findings were observed between patients with or without abnormal acid reflux. However, a higher frequency of esophageal erosions and a lower resting pressure of the inferior sphincter of the esophagus was observed in patients with abnormal acid reflux. CONCLUSIONS: Thirty percent of patients with heartburn and regurgtitation did not have abnormal acid reflux. Therefore, these symptoms are not specific for gastroesophageal reflux.
Authors: Brian Bello; Marco Zoccali; Roberto Gullo; Marco E Allaix; Fernando A Herbella; Arunas Gasparaitis; Marco G Patti Journal: J Gastrointest Surg Date: 2012-10-23 Impact factor: 3.452