title: Heartburn correlated to 24-hour pH monitoring and radiographic examination of the esophagus.
abstract: OBJECTIVE
  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 < 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 > 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 < 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 > 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.
authors.affiliation: Department of Radiology, Bowman Gray School of Medicine, Wake Forest University, Winston-Salem, North Carolina, USA.
authors.forename: D J
authors.initials: DJ
authors.lastname: Ott
authors.forename: C M
authors.initials: CM
authors.lastname: McManus
authors.forename: M S
authors.initials: MS
authors.lastname: Ledbetter
authors.forename: M Y
authors.initials: MY
authors.lastname: Chen
authors.forename: D W
authors.initials: DW
authors.lastname: Gelfand
mesh_terms: D004940:Esophageal Stenosis / Q000150:complications / Q000175:diagnosis; D004942:Esophagitis, Peptic / Q000150:complications / Q000175:diagnosis; D004947:Esophagus / Q000000981:diagnostic imaging* / Q000378:metabolism*; D005260:Female; D005764:Gastroesophageal Reflux / Q000150:complications / Q000000981:diagnostic imaging; D006356:Heartburn / Q000000981:diagnostic imaging / Q000209:etiology* / Q000378:metabolism*; D006551:Hernia, Hiatal / Q000150:complications / Q000175:diagnosis; D006801:Humans; D006863:Hydrogen-Ion Concentration; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic; D011859:Radiography