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Gastroesophageal reflux symptoms in typical and atypical GERD : Roles of gastroesophageal acid refluxes and esophageal motility
Author(s) -
Patcharatrakul Tanisa,
Gonlachanvit Sutep
Publication year - 2014
Publication title -
journal of gastroenterology and hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.214
H-Index - 130
eISSN - 1440-1746
pISSN - 0815-9319
DOI - 10.1111/jgh.12347
Subject(s) - medicine , gastroenterology , gerd , reflux , dysphagia , regurgitation (circulation) , esophageal ph monitoring , chronic cough , esophageal motility disorder , esophageal disease , esophagus , disease , surgery , asthma
Background/Aim To determine the roles of gastroesophageal acid reflux ( GER ) and esophageal dysmotility on typical and atypical GERD symptoms. Methods Two hundred thirty‐six patients (159 females, age 47 ± 14 years) with typical and atypical GERD symptom(s) for > 3 months underwent standard water perfused esophageal manometry ( EM ) and 24 h esophageal pH studies during off therapy. Results Eighty seven and 93 patients had positive lower esophageal pH tests and abnormal EM , respectively. Patients with positive lower esophageal pH test were significantly older (50 ± 13 vs 45 ± 13 years, P < 0.005) and had higher prevalence of acid regurgitation symptoms than patients with negative test (56/87 vs 72/149, P < 0.05). Patients with positive upper esophageal pH test ( n = 67) also had significantly higher prevalence of acid regurgitation symptoms (43/67 vs 74/152, P < 0.05). Prevalence of other upper gastrointestinal and respiratory symptoms were similar between patients with positive and negative upper and lower pH test. Patients with abnormal EM were significantly older (49 ± 14 vs 45 ± 13 years, P < 0.05) and had higher prevalence of chronic cough than patients with normal EM (30/93 vs 26/143, P < 0.05). In patients with positive pH tests, the prevalence of dysphagia, chronic cough, and hoarseness of voice were significantly higher in patients with abnormal than those with normal EM (18/31 vs 18/56, P < 0.05; 12/31 vs 6/56, P < 0.005 and 19/31 vs 18/56, P < 0.01, respectively). Whereas in patients with negative lower pH tests, only the prevalence of heartburn was significantly lower in patients with normal than those with abnormal EM (26/87 vs 30/62, P < 0.05). Conclusions Acid regurgitation but not heartburn was associated with GER . Esophageal dysmotility had no significant effect on acid regurgitation symptom but associated with chronic cough, hoarseness of voice, and dysphagia only in patients with abnormal esophageal acid exposure.