T1141 Positive Symptom Association Probability Predicts Symptomatic Improvement in Children with Gastroesophageal Reflux

2009 ◽  
Vol 136 (5) ◽  
pp. A-508
Author(s):  
Clara M. Loots ◽  
Marc A. Benninga ◽  
Geoffrey Davidson ◽  
Taher Omari
Keyword(s):  
Gastroesophageal Reflux ◽  
Symptomatic Improvement ◽  
Positive Symptom ◽  
Symptom Association Probability

788 VARIABLE GEOGRAPHICAL DIFFERENCES OF AMBULATORY ESOPHAGEAL REFLUX MONITORING IN MEXICO

2021 ◽  
Vol 34 (Supplement_1) ◽  
Author(s):  
Genaro Vazquez-Elizondo ◽  
José María Remes-Troche ◽  
Enrique Coss-Adame ◽  
Edgardo Suárez-Morán ◽  
Miguel Ángel Valdovinos-Díaz ◽  
...  
Keyword(s):  
Data Base ◽  
Positive Symptom ◽  
Central Mexico ◽  
Limited Information ◽  
Esophageal Reflux ◽  
Erosive Disease ◽  
Functional Heartburn ◽  
Symptom Association Probability ◽  
Common Diagnosis ◽  
Diagnostic Outcome

Abstract   Ambulatory esophageal reflux monitoring (AEpH) is useful in evaluating persistent or refractory esophageal symptoms despite adequate pharmacologic and/or surgical therapy. There is limited information whether there are geographical or regional differences in the diagnostic outcome of this test. Aim Characterize the diagnostic outcome of AEpH in a diverse population of Mexico. Analyze whether there is regional geographical diagnostic variability. Methods Data was collected from four major referral centers representing diverse geographical areas of Mexico: Mexico City-Central (two centers, years 2016-2020), Veracruz-South (years 2015-2020) and Monterrey-North (years 2013-2020). Consecutive patients undergoing AEpH with persistent GERD symptoms despite PPI therapy and negative upper endoscopy (no erosive disease >C or D LA classification) were entered into a data base and analyzed. Patients were classified as: NERD (acid exposure time (AET > 6.0%); hypersensitive esophagus (normal AET and positive symptom index (SI) or positive symptom association probability [SAP]); functional heartburn (NL AET, neg SI/SAP). Statistics: ANOVA, Chi-square and descriptive methods were used to compare variables among groups. Results 969 cases met inclusion criteria: 311 (32.1%) Central, 430 (44.3%) South, and 228 (23.5%) North. The results are summarized in the table. There were more women 618(63.8%) than men 351(36.2%); p < 0.001 with a mean age 47.7 ± 14.3. Patients were older in Central-Mexico 49.3 ± 13.6 years vs South 47.5 ± 15 and North 46.1 ± 13.6; p = 0.033. Functional heartburn was the most common diagnosis overall and more prevalent in Central-Mexico 171(55%) vs North 97(42.5%) and South 160(37.2%); p < 0.001. NERD was more predominant in the South 171(39.8%) vs North 72(31.6%) and Central-Mexico 98(31.5%); p = 0.029. Hypersensitive esophagus was more frequent in the North 59(25.9%) vs South 99(23%), and Central 42(13.5%); p < 0.001. Conclusion This is the first large data base study to evaluate the outcome of ambulatory esophageal reflux pH testing in Mexico. Our findings indicate a geographical variability of GERD phenotypes and suggest that further investigations are warranted to determine the causes of this distribution.

M1918 Correlation Between Symptomatic Improvement and Quality of Life (QOL) On Gastroesophageal Reflux Disease (GERD)

2009 ◽  
Vol 136 (5) ◽  
pp. A-446
Author(s):  
Tomohiro Kato ◽  
Kyoko Ito ◽  
Masayuki Saruta ◽  
Seiji Arihiro ◽  
Toshiki Nikami ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Gastroesophageal Reflux Disease ◽  
Gastroesophageal Reflux ◽  
Reflux Disease ◽  
Symptomatic Improvement

scholarly journals Can acid exposure time replace the DeMeester score in the diagnosis of gastroesophageal reflux-induced cough?

2021 ◽  
Vol 12 ◽  
pp. 204062232110567
Author(s):  
Yiqing Zhu ◽  
Junjun Tang ◽  
Wenbo Shi ◽  
Shengyuan Wang ◽  
Mingyan Wu ◽  
...  
Keyword(s):  
Gastroesophageal Reflux ◽  
Exposure Time ◽  
Ph Monitoring ◽  
Diagnostic Value ◽  
Acid Exposure ◽  
Optimal Cutoff ◽  
Cutoff Value ◽  
Demeester Score ◽  
Symptom Association Probability ◽  
Acid Exposure Time

Background: The objective of this study was to compare the predictive accuracy of the acid exposure time (AET) with the DeMeester score (DMS) for gastroesophageal reflux–induced cough (GERC). Methods: A total of 277 patients who underwent multichannel intraluminal impedance pH monitoring (MII-pH) were enrolled, and their clinical information and laboratory results were retrospectively analyzed. The diagnostic value of AET for GERC was compared with that of the DMS, symptom association probability (SAP), and symptom index (SI). Results: A total of 236 patients met the inclusion criteria, 150 patients (63.65%) were definitely diagnosed with GERC, including 111(74%) acid GERC and 39 (26%) nonacid GERC. The optimal cutoff value of AET for diagnosing GERC was AET > 4.8%, and its diagnostic value was equal to that of DMS > 14.7 (AUC = 0.827 versus 0.818, p = 0.519) and was superior to that of SAP (AUC = 0.827 versus 0.689, p = 0.000) and SI (AUC = 0.827 versus 0.688, p = 0.000). When using both DMS > 14.7 and AET > 4.8% or either of the two for the diagnosis of GERC, the diagnosis rate was not improved over using DMS > 14.7 alone. The diagnostic value of AET and DMS for acid GERC were both high and equivalent (AUC = 0.925 versus 0.922, p = 0.95). The optimal cutoff value of AET for diagnosing acid GERC was AET > 6.2%. Conclusion: AET and DMS are both equal in discriminating GERC. A GERC diagnosis should be considered when AET > 4.8%, whereas an acid GERC diagnosis should be considered when AET > 6.2%.

Symptomatic improvement in gastroesophageal reflux disease (GERD) following laparoscopic Roux-en-Y gastric bypass

2002 ◽  
Vol 16 (7) ◽  
pp. 1027-1031 ◽  
Author(s):  
E. E. Rrezza ◽  
S. Ikramuddin ◽  
W. Gourash ◽  
T. Rakitt ◽  
A. Kingston ◽  
...  
Keyword(s):  
Gastric Bypass ◽  
Gastroesophageal Reflux Disease ◽  
Gastroesophageal Reflux ◽  
Reflux Disease ◽  
Symptomatic Improvement

scholarly journals Management of Gastroesophageal Reflux Disease: A Review of Medical and Surgical Management

2014 ◽  
Vol 2014 ◽  
pp. 1-5 ◽  
Author(s):  
Nirali Shah ◽  
Sandhya Iyer
Keyword(s):  
Gastroesophageal Reflux Disease ◽  
Gastroesophageal Reflux ◽  
Reflux Disease ◽  
Public Hospital ◽  
Symptomatic Improvement ◽  
Long Term Effects ◽  
Interventional Study ◽  
Urban Indian ◽  
Larger Sample

Background. Gastroesophageal reflux disease currently accounts for the majority of esophageal pathologies. This study is an attempt to help us tackle the diagnostic and therapeutic challenges of this disease. This study specifically focuses on patients in the urban Indian setup.Materials and Methods. This study was a prospective interventional study carried out at a teaching public hospital in Mumbai from May 2010 to September 2012. Fifty patients diagnosed with gastroesophageal reflux disease (confirmed by endoscopy and esophageal manometry) were chosen for the study.Results. Fifty patients were included in the study. Twenty patients showed symptomatic improvement after three months and were thus managed conservatively, while 30 patients did not show any improvement in symptoms and were eventually operated.Conclusion. We suggest that all patients diagnosed to have gastroesophageal reflux disease should be subjected to 3 months of conservative management. In case of no relief of symptoms, patients need to be subjected to surgery. Laparoscopic Toupet's fundoplication is an effective and feasible surgical treatment option for such patients, associated with minimal side effects. However, the long-term effects of this form of treatment still need to be evaluated further with a larger sample size and a longer followup.

scholarly journals Impact of prolonged 48-h wireless capsule esophageal pH monitoring on diagnosis of gastroesophageal reflux disease and evaluation of the relationship between symptoms and reflux episodes

2011 ◽  
Vol 48 (1) ◽  
pp. 24-29 ◽  
Author(s):  
Gerson Ricardo de Souza Domingues ◽  
Joaquim Prado P. Moraes-Filho ◽  
Aline Gonçalves Leite Domingues
Keyword(s):  
Gastroesophageal Reflux Disease ◽  
Gastroesophageal Reflux ◽  
Reflux Disease ◽  
Diagnostic Yield ◽  
Ph Monitoring ◽  
Esophageal Acid Exposure ◽  
Acid Exposure ◽  
Esophageal Ph ◽  
Symptom Association Probability ◽  
Wireless Capsule

CONTEXT: Gastroesophageal reflux disease is one of the most common digestive diseases and an important cause of distress to patients. Diagnosis of this condition can require ambulatory pH monitoring. OBJECTIVES: To determine the diagnostic yield of a wireless ambulatory pH monitoring system of 48-hours, recording to diagnose daily variability of abnormal esophageal acid exposure and its symptom association. METHODS: A total of 100 consecutive patients with persistent reflux symptoms underwent wireless pH capsule placement from 2004 to 2009. The wireless pH capsule was deployed 5 cm proximal to the squamocolumnar junction after lower esophageal sphincter was manometrically determined. The pH recordings over 48-h were obtained after uploading data to a computer from the receiver that recorded pH signals from the wireless pH capsule. The following parameters were analyzed: (1) percentual time of distal esophageal acid exposure; (2) symptom association probability related to acid reflux. The results between the first and the second day were compared, and the diagnostic yield reached when the second day monitoring was included. RESULTS: Successful pH data over 48-h was obtained in 95% of patients. Nearly one quarter of patients experienced symptoms ranging from a foreign body sensation to chest pain. Forty-eight hours pH data analysis was statistically significant when compared to isolated analysis of day 1 and day 2. Study on day 2 identified seven patients (30.4%) that would be missed if only day 1 was analyzed. Three patients (18.7%) out of 16 patients with normal esophageal acid exposure on both days, showed positive symptom association probability, which generated an increase in diagnostic yield of 43.4%. CONCLUSION: Esophageal pH monitoring with wireless capsule is safe, well tolerated, does not require sedation. The extended 48-h period of study poses an increased yield to diagnose gastroesophageal reflux disease patients.

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