Abstract
The purpose of this study was to determine whether measurement of salivary/sputum pepsin could be used as a surrogate marker for detecting gastroesophageal reflux using 24-hr esophageal pH monitoring as the gold standard. Patients with gastroesophageal reflux symptoms underwent simultaneous 24-hr esophageal pH monitoring and collection of saliva and sputum samples for pepsin measurement using a recently developed assay. In all, 16 patients provided 19 positive (10.6%) and 161 negative pepsin assays. The mean pH values for the positive pepsin samples were lower then the negative samples at both the proximal [5.34 (95% CI, 4.94–5.75) vs 6.12 (95% CI, 6.03–6.20; P <0.01)] and distal [4.97 (95% CI, 4.61–5.33) vs 6.03 (95% CI, 5.92–6.15; P < 0.01)] pH probes. Proximal esophageal reflux was not detected in patients who had a negative pepsin assay (N = 12); in contrast, proximal esophageal reflux was documented in three of four patients with a positive assay. In conclusion, detection of pepsin in the saliva and/or sputum may provide a noninvasive method to test for the proximal reflux of gastric contents.
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Potluri, S., Friedenberg, F., Parkman, H.P. et al. Comparison of a Salivary/Sputum Pepsin Assay with 24-Hour Esophageal pH Monitoring for Detection of Gastric Reflux into the Proximal Esophagus, Oropharynx, and Lung. Dig Dis Sci 48, 1813–1817 (2003). https://doi.org/10.1023/A:1025467600662
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DOI: https://doi.org/10.1023/A:1025467600662