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Digestive Diseases and Sciences

, Volume 58, Issue 10, pp 2933–2939 | Cite as

The Value of Early Wireless Esophageal pH Monitoring in Diagnosing Functional Heartburn in Refractory Gastroesophageal Reflux Disease

  • Eun-Young Park
  • Myung-Gyu ChoiEmail author
  • Meonggi Baeg
  • Chul-Hyun Lim
  • Jinsu Kim
  • Yukyung Cho
  • Jaemyung Park
  • Inseok Lee
  • Sangwoo Kim
  • Kyuyong Choi
Original Article

Abstract

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.

Keywords

Esophageal pH monitoring Gastroesophageal reflux Heartburn Proton pump inhibitors 

Notes

Acknowledgments

This work was supported by research grant from Jeil Pharmaceuticals Co, Ltd.

Conflict of interest

None.

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Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  • Eun-Young Park
    • 1
  • Myung-Gyu Choi
    • 1
    Email author
  • Meonggi Baeg
    • 1
  • Chul-Hyun Lim
    • 1
  • Jinsu Kim
    • 1
  • Yukyung Cho
    • 1
  • Jaemyung Park
    • 1
  • Inseok Lee
    • 1
  • Sangwoo Kim
    • 1
  • Kyuyong Choi
    • 1
  1. 1.Division of Gastroenterology, Department of Internal Medicine, Seoul St. Mary’s HospitalThe Catholic University of KoreaSeoulKorea

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