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The symptom index: a clinically important parameter of ambulatory 24-hour esophageal pH monitoring.
Am J Gastroenterol 1988; 83(4):358-61AJ

Abstract

Ambulatory 24-h esophageal pH monitoring is an accurate quantitative test of gastroesophageal reflux (GER). However, it does not answer the question: are the patients' symptoms due to GER? We developed a numerical scale to quantify the percent association between symptoms and pH less than 4--the symptom index (SI). In 100 consecutive patients with heartburn or chest pain, the SI for the chief complaint was either high (greater than 75%) or low (less than 25%) in 77% of cases. A similar bimodal distribution was seen when heartburn or chest pain symptoms were individually evaluated. There was a good association between high SI and the presence of GER (97.5%), as well as low SI and a normal 24-h pH study (81.1%). Endoscopy was normal in 89.5% of patients with low SI, but patients with high SI had esophagitis in only 69.7% of cases. The Bernstein test showed a poor association with the SI. Therefore, the SI gives clinically relevant information regarding the role of acid reflux and patient's symptoms. We believe this simple calculated index should be included in the analysis of 24-h esophageal pH studies.

Authors+Show Affiliations

Bowman Gray School of Medicine of Wake Forest University, Winston-Salem, North Carolina.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

3348191

Citation

Wiener, G J., et al. "The Symptom Index: a Clinically Important Parameter of Ambulatory 24-hour Esophageal pH Monitoring." The American Journal of Gastroenterology, vol. 83, no. 4, 1988, pp. 358-61.
Wiener GJ, Richter JE, Copper JB, et al. The symptom index: a clinically important parameter of ambulatory 24-hour esophageal pH monitoring. Am J Gastroenterol. 1988;83(4):358-61.
Wiener, G. J., Richter, J. E., Copper, J. B., Wu, W. C., & Castell, D. O. (1988). The symptom index: a clinically important parameter of ambulatory 24-hour esophageal pH monitoring. The American Journal of Gastroenterology, 83(4), pp. 358-61.
Wiener GJ, et al. The Symptom Index: a Clinically Important Parameter of Ambulatory 24-hour Esophageal pH Monitoring. Am J Gastroenterol. 1988;83(4):358-61. PubMed PMID: 3348191.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The symptom index: a clinically important parameter of ambulatory 24-hour esophageal pH monitoring. AU - Wiener,G J, AU - Richter,J E, AU - Copper,J B, AU - Wu,W C, AU - Castell,D O, PY - 1988/4/1/pubmed PY - 1988/4/1/medline PY - 1988/4/1/entrez SP - 358 EP - 61 JF - The American journal of gastroenterology JO - Am. J. Gastroenterol. VL - 83 IS - 4 N2 - Ambulatory 24-h esophageal pH monitoring is an accurate quantitative test of gastroesophageal reflux (GER). However, it does not answer the question: are the patients' symptoms due to GER? We developed a numerical scale to quantify the percent association between symptoms and pH less than 4--the symptom index (SI). In 100 consecutive patients with heartburn or chest pain, the SI for the chief complaint was either high (greater than 75%) or low (less than 25%) in 77% of cases. A similar bimodal distribution was seen when heartburn or chest pain symptoms were individually evaluated. There was a good association between high SI and the presence of GER (97.5%), as well as low SI and a normal 24-h pH study (81.1%). Endoscopy was normal in 89.5% of patients with low SI, but patients with high SI had esophagitis in only 69.7% of cases. The Bernstein test showed a poor association with the SI. Therefore, the SI gives clinically relevant information regarding the role of acid reflux and patient's symptoms. We believe this simple calculated index should be included in the analysis of 24-h esophageal pH studies. SN - 0002-9270 UR - https://www.unboundmedicine.com/medline/citation/3348191/The_symptom_index:_a_clinically_important_parameter_of_ambulatory_24_hour_esophageal_pH_monitoring_ L2 - https://medlineplus.gov/gerd.html DB - PRIME DP - Unbound Medicine ER -