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Characteristics of symptomatic GERD in Japanese patients based on 24-h pH monitoring

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Abstract

Background

We assessed the characteristics of symptomatic gastroesophageal reflux disease (sGERD), defined as the presence of symptoms, but no endoscopic findings of reflux esophagitis, in Japanese.

Methods

Sixty-three patients were diagnosed with sGERD, and underwent 24-h esophagogastric pH monitoring (32 men; mean age, 50.5 years). Patients were classified into the following three groups : reflux group (group R), minor reflux group (group MR), and a no-reflux group (group N) by the percentage of time at pH below 4 (group R, 4.0% or more; group MR, 2.0%–3.9%; group N, 0–1.9%). Hiatal hernia was assessed based on the Anatomy-Function-Pathology (AFP) classification, and the shape of the cardia was assessed based on valve factors (V0–V3).

Results

There were 13 patients (21%) in group R, 17 (27%) in group MR, and 33 (52%) in group N. Hiatal hernia was present in 11 patients (85%) in group R, 14 (82%) in group MR, and 22 (67%) in group N. Patients grouped according to presence of V2/V3 (chalasia) accounted for 100% of those in group R, 71% of those in group MR and 70% of those in group N. Hiatal hernia was present in 10 (91%), 10 (83%), and 6 patients (86%) who had 50 or more episodes of esophageal acid reflux per day in group R, group MR, and group N, respectively.

Conclusions

Reflux (percentage of time below pH 4, 4%) was seen in only about 20% of the patients with sGERD, and this percentage of patients with reflux was lower compared to the data reported from the United States and Europe. The percentage of patients who had a hiatal hernia or chalasia was high in all these groups, and this seemed to be a characteristic cause of sGERD in Japanese.

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Authors and Affiliations

  1. Department of Surgery, Jikei University School of Medicine, 3-25-8 Nishi-shinbashi, Minato-ku, Tokyo, 105-8461, Japan

    Nobuo Omura, Hideyuki Kashiwagi, Fumiaki Yano, Kazuto Tsuboi & Katsuhiko Yanaga

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  1. Nobuo Omura
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  2. Hideyuki Kashiwagi
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  3. Fumiaki Yano
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  4. Kazuto Tsuboi
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  5. Katsuhiko Yanaga
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Omura, N., Kashiwagi, H., Yano, F. et al. Characteristics of symptomatic GERD in Japanese patients based on 24-h pH monitoring. J Gastroenterol 40, 791–795 (2005). https://doi.org/10.1007/s00535-005-1629-5

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  • DOI: https://doi.org/10.1007/s00535-005-1629-5

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