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Postprandial oesophageal integrated acidity is a reliable predictor of gastro‐oesophageal reflux disease
Author(s) -
Shih G. L.,
Brensinger C. M.,
Katzka D. A.,
Metz D. C.
Publication year - 2005
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.1365-2036.2005.02509.x
Subject(s) - postprandial , reflux , gastroenterology , medicine , gastro , esophageal disease , disease , esophagus , insulin
Summary Background : Measurement of oesophageal acid exposure parameters postprandially has been shown to distinguish gastro‐oesophageal reflux disease patients from normal individuals. Aims : To calculate the accuracy of postprandial oesophageal integrated acidity in diagnosing gastro‐oesophageal reflux disease. Methods : Ambulatory 24‐h pH studies of 626 patients were analysed retrospectively. Gastro‐oesophageal reflux disease, defined as pH < 4 for >4.2% of time, was identified in 305 subjects. Postprandial oesophageal integrated acidity was measured for 2 and 3 h after the largest meal peak as determined from gastric pH. Postprandial symptom‐associated probability was calculated. Results : Gastro‐oesophageal reflux disease subjects had a greater postprandial oesophageal integrated acidity than non‐gastro‐oesophageal reflux disease subjects [median (IQR): 0.57 (0.08–2.66) vs. 0.03 (0.01–0.15) mmol*h/L]. Median postprandial oesophageal integrated acidity did not differ with gender or age in gastro‐oesophageal reflux disease and non‐gastro‐oesophageal reflux disease subjects ( P > 0.05 for all). A 3‐h postprandial oesophageal integrated acidity value of 0.121 mmol*h/L had a 71.1% sensitivity and 71.7% specificity in diagnosing gastro‐oesophageal reflux disease. Gastro‐oesophageal reflux disease subjects with symptoms had a higher postprandial oesophageal integrated acidity than those without ( P = 0.043), whereas non‐gastro‐oesophageal reflux disease subjects with and without symptoms did not differ ( P = 0.74). The correlation between symptom‐associated probability and postprandial oesophageal integrated acidity was poor (gastro‐oesophageal reflux disease: r = 0.15; non‐gastro‐oesophageal reflux disease: r = 0.25). Conclusion : Postprandial oesophageal integrated acidity provides a robust estimation of oesophageal acid exposure and may predict symptoms in gastro‐oesophageal reflux disease patients.