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[Perception of symptoms with minimal reductions of esophageal pH in patients with erosive and non-erosive GERD].
Rev Gastroenterol Mex 2004 Jan-Mar; 69(1):30-6RG

Abstract

BACKGROUND

Patients with gastrointestinal reflux disease GERD perceive < 5% of acid reflux episodes, independently of GERD type. The role of minimal changes on esophageal pH (1 or 2 units) on development of symptoms is unknown.

OBJECTIVE

To evaluate symptom perception and its relationship with minimal changes on esophageal pH in patients with erosive and non-erosive GERD (NERD).

PATIENTS AND METHODS

We evaluated consecutive patients with symptomatic GERD. All patients had endoscopy in the previous 8 weeks. All patients underwent 24-h esophageal pH-monitoring. Abnormal pH-metry was defined as % time of pH < 4 > 4.2. Symptom index (SI) was considered positive when > or = 50. We also calculated SI at pH 5 and pH 6. Patients with GERD were classified into three groups: 1) abnormal pH and negative SI. For statistical analysis, we used the test-Student, chi 2, and ANOVA test. P < 0.05 was considered statistically significant.

RESULTS

We evaluated 120 patients, 79 (66%) females and 41 (34%) males with mean age of 47.8 years (range 21-83 years). Eighty three (69%) patients had NERD and 37 (31%), erosive esophagitis (EE). Seventy two patients (87%) with NERD and 36 (97%) with erosive GERD developed symptoms during the study. NERD patients had mean of 69 reflux episodes compared with 184 of patients with EE. Perception of reflux symptoms was significantly higher in the group with EE (3.4 vs. 1.02 p < 0.0001). Among patients with NERD, 33% had abnormal pH-metry and 67%, a normal test. Of these patients, nine (16%) had normal pH test and positive SI, and 47 (83%) normal pH test and negative SI. There was no difference in symptom perception among the three groups. Patients with NERD and abnormal pH had similar SI patients with EE; 4% of patients with normal pH and negative SI at pH 4 had positive SI when calculated at pH 5, and 68% when SI was calculated at pH 6.

CONCLUSIONS

The majority of acid reflux episodes are not perceived and this phenomenon is independent of erosive or non-erosive GERD. Patients with erosive esophagitis had significantly higher esophageal acid exposure than patients with NERD. Minimal changes in esophageal pH (1 or 2 pH units) increases SI in patients with GERD, especially in those with normal esophageal acid exposure.

Authors+Show Affiliations

Laboratorio de Motilidad Gastrointestinal, Departamento de Gastroenterología, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Vasco de Quiroga 15, Sección XVI, Tlalpan CP 14000 México, D.F.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

English Abstract
Journal Article

Language

spa

PubMed ID

15193061

Citation

Remes-Troche, José María, et al. "[Perception of Symptoms With Minimal Reductions of Esophageal pH in Patients With Erosive and Non-erosive GERD]." Revista De Gastroenterologia De Mexico, vol. 69, no. 1, 2004, pp. 30-6.
Remes-Troche JM, Gómez-Escudero O, Ruíz JC, et al. [Perception of symptoms with minimal reductions of esophageal pH in patients with erosive and non-erosive GERD]. Rev Gastroenterol Mex. 2004;69(1):30-6.
Remes-Troche, J. M., Gómez-Escudero, O., Ruíz, J. C., Schmulson, M. J., & Valdovinos Díaz, M. A. (2004). [Perception of symptoms with minimal reductions of esophageal pH in patients with erosive and non-erosive GERD]. Revista De Gastroenterologia De Mexico, 69(1), pp. 30-6.
Remes-Troche JM, et al. [Perception of Symptoms With Minimal Reductions of Esophageal pH in Patients With Erosive and Non-erosive GERD]. Rev Gastroenterol Mex. 2004;69(1):30-6. PubMed PMID: 15193061.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - [Perception of symptoms with minimal reductions of esophageal pH in patients with erosive and non-erosive GERD]. AU - Remes-Troche,José María, AU - Gómez-Escudero,Octavio, AU - Ruíz,Juan Carlos, AU - Schmulson,Max Julio, AU - Valdovinos Díaz,Miguel Angel, PY - 2004/6/15/pubmed PY - 2004/8/31/medline PY - 2004/6/15/entrez SP - 30 EP - 6 JF - Revista de gastroenterologia de Mexico JO - Rev Gastroenterol Mex VL - 69 IS - 1 N2 - BACKGROUND: Patients with gastrointestinal reflux disease GERD perceive < 5% of acid reflux episodes, independently of GERD type. The role of minimal changes on esophageal pH (1 or 2 units) on development of symptoms is unknown. OBJECTIVE: To evaluate symptom perception and its relationship with minimal changes on esophageal pH in patients with erosive and non-erosive GERD (NERD). PATIENTS AND METHODS: We evaluated consecutive patients with symptomatic GERD. All patients had endoscopy in the previous 8 weeks. All patients underwent 24-h esophageal pH-monitoring. Abnormal pH-metry was defined as % time of pH < 4 > 4.2. Symptom index (SI) was considered positive when > or = 50. We also calculated SI at pH 5 and pH 6. Patients with GERD were classified into three groups: 1) abnormal pH and negative SI. For statistical analysis, we used the test-Student, chi 2, and ANOVA test. P < 0.05 was considered statistically significant. RESULTS: We evaluated 120 patients, 79 (66%) females and 41 (34%) males with mean age of 47.8 years (range 21-83 years). Eighty three (69%) patients had NERD and 37 (31%), erosive esophagitis (EE). Seventy two patients (87%) with NERD and 36 (97%) with erosive GERD developed symptoms during the study. NERD patients had mean of 69 reflux episodes compared with 184 of patients with EE. Perception of reflux symptoms was significantly higher in the group with EE (3.4 vs. 1.02 p < 0.0001). Among patients with NERD, 33% had abnormal pH-metry and 67%, a normal test. Of these patients, nine (16%) had normal pH test and positive SI, and 47 (83%) normal pH test and negative SI. There was no difference in symptom perception among the three groups. Patients with NERD and abnormal pH had similar SI patients with EE; 4% of patients with normal pH and negative SI at pH 4 had positive SI when calculated at pH 5, and 68% when SI was calculated at pH 6. CONCLUSIONS: The majority of acid reflux episodes are not perceived and this phenomenon is independent of erosive or non-erosive GERD. Patients with erosive esophagitis had significantly higher esophageal acid exposure than patients with NERD. Minimal changes in esophageal pH (1 or 2 pH units) increases SI in patients with GERD, especially in those with normal esophageal acid exposure. SN - 0375-0906 UR - https://www.unboundmedicine.com/medline/citation/15193061/[Perception_of_symptoms_with_minimal_reductions_of_esophageal_pH_in_patients_with_erosive_and_non_erosive_GERD]_ L2 - https://medlineplus.gov/gerd.html DB - PRIME DP - Unbound Medicine ER -