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Endoscopy‐negative acid reflux disease
Author(s) -
SMOUT A. J. P. M.
Publication year - 1997
Publication title -
alimentary pharmacology and therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.308
H-Index - 177
eISSN - 1365-2036
pISSN - 0269-2813
DOI - 10.1111/j.1365-2036.1997.tb00798.x
Subject(s) - medicine , heartburn , endoscopy , reflux , gastroenterology , disease , hiatal hernia , regurgitation (circulation) , esophagitis , esophageal disease , gerd , quality of life (healthcare) , severity of illness , esophagus , nursing
SUMMARY Recent clinical trials have yielded important new information about endoscopy‐negative acid reflux disease. Patients with this disease tend to be younger than those with endoscopy‐positive disease and are more likely to be female, thin and without hiatal hernia. The trials have shown that, in patients with endoscopy‐negative reflux disease, symptoms (particularly heartburn) tend to be less severe and less frequent than in patients with endoscopy‐positive disease. The overlap between the groups is such, however, that the symptoms cannot be used to distinguish reflux patients with oesophagitis from those without. Approximately 50% of patients with endoscopy‐negative disease were found to have levels of oesophageal acid exposure that fell within the normal range. Oesophageal pH monitoring is therefore of limited value in patients with endoscopy‐negative reflux disease, unless the test focuses on analysis of the correlation between symptoms and episodes of reflux. New studies have also made clear, for the first time, that endoscopy‐negative acid reflux disease has a measurable and substantial impact on the patients' general well‐being and quality of life. Patients with endoscopy‐negative disease have quality‐of‐life scores that are similar to those found in patients with oesophagitis.