Heartburn correlated to 24-hour pH monitoring and radiographic examination of the esophagus
Ott, D.J.; McManus, C.M.; Ledbetter, M.S.; Chen, M.Y.; Gelfand, D.W.
American Journal of Gastroenterology 92(10): 1827-1830
1997
ISSN/ISBN: 0002-9270 PMID: 9382045 Document Number: 469541
Objectives: Study relationship of gastroesophageal reflux disease to findings on radiographic examination of the esophagus. Methods: We correlated heartburn (HB) in 360 patients (174 women; 186 men; mean age, 53 yr) to results of pH monitoring (pHM) and radiographic examination of the esophagus. Radiographic findings were categorized as normal (n = 129), hiatal hernia (HH) only (n = 173), reflux esophagitis (n = 50), or peptic stricture (n = 8) (ES; 58). Abnormal pHM was defined as total percentage of esophageal acid exposure time (pH lt 4) of 6% or greater. Results: pHM was abnormal in 41 (31%) of 132 patients with HB versus 54 (24%) of 228 without the symptom (p gt 0.05). Radiographic correlation showed abnormal pHM in only 21 (16%) of 129 patients with a normal esophagus, 52 (30%) of 173 with HH, and 22 (38%) of 58 with ES, which was significantly lower for those with a normal esophagus. In 132 patients with HB, those with normal esophagus had lower abnormal pHM (2 of 38; 5%) compared with patients with HH (24 of 64; 38%) or with ES (15 of 30; 50%) (p lt 0.05). In the 228 patients without HB, abnormal pHM was found in 19 (21%) of 91 with a normal esophagus, 28 (26%) of 109 with HH, and 7 (25%) of 28 with ES (p gt 0.05). Conclusions: (1) pHM findings did not correlate with presence or absence of HB; (2) pHM is usually normal in patients with normal esophagus on RE; (3) pHM is also usually normal in patients with HB and normal esophagus on RE; and (4) pHM is often normal in patients with radiographic findings of reflux esophagitis or peptic stricture.