PMID- 19337627
OWN - NLM
STAT- MEDLINE
DCOM- 20100511
LR  - 20111209
IS  - 1841-8724 (Print)
IS  - 1841-8724 (Linking)
VI  - 18
IP  - 1
DP  - 2009 Mar
TI  - 24-hour ambulatory pH-metry in patients with refractory heartburn: a prospective 
      study.
PG  - 11-5
AB  - BACKGROUND: Gastroesophageal reflux disease (GERD) is a chronic condition that 
      affects a large proportion of population. The aim of our study was to determine 
      what percentages of patients with persistent heartburn on acid suppressive 
      therapy have evidence of reflux disease while off acid suppressive therapy. 
      METHODS: In a prospective study 48 patients with refractory heartburn from 
      Taleghani Hospital were enrolled who had been on a double dose of proton pump 
      inhibitor (PPI) for 8 weeks without improvement. Because of low index of 
      suspicion for GERD as an etiology, all the patients underwent 24h pH-metry while 
      off PPI. The variables of pH-metry such as the fraction time of pH <4 were 
      evaluated by comparing to normal volunteers. RESULTS: The mean "number of acid 
      refluxes" was 49.98 in upright position and 6.29 in supine position. The mean 
      "longest acid reflux" duration was 2.98 minutes in upright and 3.13 minutes in 
      supine position. The total time fraction of pH <4 was 2.97% in upright position, 
      1.2 % in supine position and 2.74% in postprandial state. The mean DeMeester 
      score was 10.06 (SD=10.48). However, the difference in the total fraction of time 
      with pH <4 was not significant. CONCLUSION: Our study showed that most of the 
      patients with refractory heartburn did not have acid reflux. Patients with 
      refractory heartburn often do not have evidence of reflux disease on pH 
      monitoring, thus evaluating these patients should be performed while on acid 
      suppressive therapy (using impedance-pH monitoring) in order to clarify the 
      relationship between symptoms and acid and non-acid reflux.
FAU - Talaie, Ramin
AU  - Talaie R
AD  - Research Center for Gastroenterology and Liver Diseases, Shahid Beheshti 
      University of Medical Sciences, Tehran, Iran. tala_1349@yahoo.com
FAU - Forootan, Mojgan
AU  - Forootan M
FAU - Donboli, Kianoush
AU  - Donboli K
FAU - Dadashzadeh, Nahid
AU  - Dadashzadeh N
FAU - Sadeghi, Amir
AU  - Sadeghi A
FAU - Poorsaadat, Sara
AU  - Poorsaadat S
FAU - Moghimi, Bijan
AU  - Moghimi B
FAU - Mohammad Alizadeh, Amir Houshang
AU  - Mohammad Alizadeh AH
FAU - Zali, Mohammad Reza
AU  - Zali MR
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - Romania
TA  - J Gastrointestin Liver Dis
JT  - Journal of gastrointestinal and liver diseases : JGLD
JID - 101272825
RN  - 0 (Proton Pump Inhibitors)
SB  - IM
CIN - J Gastrointestin Liver Dis. 2009 Mar;18(1):9-10. PMID: 19337626
MH  - Adolescent
MH  - Adult
MH  - *Esophageal pH Monitoring
MH  - Female
MH  - Gastroesophageal Reflux/complications/*diagnosis/drug therapy
MH  - Heartburn/*etiology/prevention & control
MH  - Humans
MH  - Male
MH  - Manometry
MH  - Middle Aged
MH  - Predictive Value of Tests
MH  - Prospective Studies
MH  - Proton Pump Inhibitors/*therapeutic use
MH  - Severity of Illness Index
MH  - Supine Position
MH  - Time Factors
MH  - Treatment Failure
MH  - Young Adult
EDAT- 2009/04/02 09:00
MHDA- 2010/05/12 06:00
CRDT- 2009/04/02 09:00
PHST- 2009/04/02 09:00 [entrez]
PHST- 2009/04/02 09:00 [pubmed]
PHST- 2010/05/12 06:00 [medline]
AID - 1 [pii]
PST - ppublish
SO  - J Gastrointestin Liver Dis. 2009 Mar;18(1):11-5.