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Accuracy of diagnosing gastroesophageal reflux disease by GerdQ , esophageal impedance monitoring and histology
Author(s) -
Zhou Li Ya,
Wang Ye,
Lu Jing Jing,
Lin Lin,
Cui Rong Li,
Zhang He Jun,
Xue Yan,
Ding Shi Gang,
Lin San Ren
Publication year - 2014
Publication title -
journal of digestive diseases
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.684
H-Index - 51
eISSN - 1751-2980
pISSN - 1751-2972
DOI - 10.1111/1751-2980.12135
Subject(s) - gerd , medicine , reflux , gastroenterology , proton pump inhibitor , esophageal ph monitoring , endoscopy , disease , biopsy
Objective To assess the performance of self‐assessment gastroesophageal reflux disease questionnaire ( GerdQ ), 24‐h impedance monitoring, proton pump inhibitor ( PPI ) test and intercellular space of esophageal mucosal epithelial cells in the diagnosis of gastroesophageal reflux disease ( GERD ). Methods Patients with symptoms suspected of GERD were administered the GerdQ and underwent endoscopy (measurement of intercellular space in the biopsy specimen sampling at 2 cm above the Z‐line) and 24‐h impedance pH monitoring, together with a 2‐week experimental treatment with esomeprazole. Results A total of 636 patients were included for the final analysis, including 352 with GERD . The sensitivity and specificity of GerdQ and 24‐h impedance monitoring for diagnosing GERD were 57.7% and 48.9%, and 66.4% and 43.3%, respectively. The sensitivity of 24‐h impedance pH monitoring increased to 93.7%. The sensitivity and specificity of dilated intercellular spaces (DIS) (≥0.9 μm) for diagnosing GERD were 61.2% and 56.1%, respectively, whereas those for PPI test were 70.5% and 44.4%. Conclusions GerdQ score or PPI test alone cannot accurately diagnose GERD in a C hinese population suspected of GERD . A definitive diagnosis of GERD still depends on endoscopy or 24‐h pH monitoring. 24‐h impedance pH monitoring may increase the sensitivity for diagnosing GERD by 20%; however, when used alone, it results in poor specificity in patients without acid suppressive therapy.