PMID- 23765257
OWN - NLM
STAT- MEDLINE
DCOM- 20131203
LR  - 20220317
IS  - 1573-2568 (Electronic)
IS  - 0163-2116 (Linking)
VI  - 58
IP  - 10
DP  - 2013 Oct
TI  - The value of early wireless esophageal pH monitoring in diagnosing functional 
      heartburn in refractory gastroesophageal reflux disease.
PG  - 2933-9
LID - 10.1007/s10620-013-2728-4 [doi]
AB  - BACKGROUND AND AIMS: It is difficult to differentiate functional heartburn from 
      proton pump inhibitor (PPI) failure. The aims of this study were to assess the 
      role of early wireless esophageal pH monitoring in patients referred with 
      gastroesophageal reflux disease (GERD) and to identify differences in the 
      clinical spectrum among GERD subtypes. METHODS: We enrolled consecutive referred 
      patients with suspected GERD. After endoscopy on the first visit, all underwent 
      wireless esophageal pH monitoring when off the PPI. RESULTS: Two hundred thirty 
      patients were enrolled. These patients were classified into a reflux esophagitis 
      group (20, 8.7 %) and a normal endoscopic findings group (210, 91.3 %). Among the 
      210 patients in the normal endoscopic findings group, 63 (27.4 %) were diagnosed 
      with pathological reflux, 35 (15.2 %) with hypersensitive esophagus, 87 (37.8 %) 
      with normal acid exposure with negative symptom association, and 25 (10.9 %) with 
      test failure. These groups did not differ in age, body mass index, smoking habit, 
      alcohol consumption, symptom severity, quality of life, presence of atypical 
      symptoms, overlap with irritable bowel syndrome, and the frequency of 
      somatization, depression, and anxiety. PPI responses were evaluated in 135 
      patients. Fifty patients (37.0 %) were not responsive to the 4-week treatment; 26 
      (19.3 %) were diagnosed with refractory non-erosive gastroesophageal disease, and 
      24 (17.8 %) with functional heartburn. The demographics and clinical and 
      psychological characteristics did not differ between the two groups. CONCLUSIONS: 
      Demographic characteristics and symptom patterns alone cannot differentiate 
      functional heartburn from various subtypes of GERD. Wireless esophageal pH 
      monitoring should be considered for the initial evaluation of GERD in the 
      tertiary referral setting.
FAU - Park, Eun-Young
AU  - Park EY
AD  - Division of Gastroenterology, Department of Internal Medicine, Seoul St. Mary's 
      Hospital, The Catholic University of Korea, 505, Banpo-Dong, Seocho-Gu, Seoul, 
      137-040, Korea, peyoung97@hanmail.net.
FAU - Choi, Myung-Gyu
AU  - Choi MG
FAU - Baeg, Meonggi
AU  - Baeg M
FAU - Lim, Chul-Hyun
AU  - Lim CH
FAU - Kim, Jinsu
AU  - Kim J
FAU - Cho, Yukyung
AU  - Cho Y
FAU - Park, Jaemyung
AU  - Park J
FAU - Lee, Inseok
AU  - Lee I
FAU - Kim, Sangwoo
AU  - Kim S
FAU - Choi, Kyuyong
AU  - Choi K
LA  - eng
PT  - Evaluation Study
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20130614
PL  - United States
TA  - Dig Dis Sci
JT  - Digestive diseases and sciences
JID - 7902782
RN  - 0 (Proton Pump Inhibitors)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Diagnosis, Differential
MH  - Drug Resistance
MH  - *Esophageal pH Monitoring
MH  - Female
MH  - Gastroesophageal Reflux/complications/*diagnosis/drug therapy
MH  - Heartburn/*diagnosis/drug therapy/etiology
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Proton Pump Inhibitors/therapeutic use
MH  - Retrospective Studies
MH  - Treatment Failure
EDAT- 2013/06/15 06:00
MHDA- 2013/12/16 06:00
CRDT- 2013/06/15 06:00
PHST- 2013/02/12 00:00 [received]
PHST- 2013/05/19 00:00 [accepted]
PHST- 2013/06/15 06:00 [entrez]
PHST- 2013/06/15 06:00 [pubmed]
PHST- 2013/12/16 06:00 [medline]
AID - 10.1007/s10620-013-2728-4 [doi]
PST - ppublish
SO  - Dig Dis Sci. 2013 Oct;58(10):2933-9. doi: 10.1007/s10620-013-2728-4. Epub 2013 
      Jun 14.