The screening sensitivity of endoscopy, acid perfusion test and 24-hour pH-monitoring to evaluate esophagitis in patients with heartburn and histological esophagitis.
The sensitivity of endoscopic examinations, acid perfusion test and 24-hour esophageal pH-monitoring, were studied in patients with heartburn. Thirty six adult patients with histological esophagitis were included in this prospective study. Endoscopy showed esophageal lesion in 18/36 (sensitivity of 50%): esophagitis grade I in 10 (55.6%) and, grade II in eight (44.4%). Acid perfusion test was positive in 10/25 (sensitivity of 40%) of the patients submitted to the test. Twenty-four-hour pH-monitoring was positive in 17/29 patients (sensitivity of 58.6%): eight (61.5%) did not have esophageal lesion at endoscopy, two (25%) had esophagitis grade I and seven (87.5%) had esophagitis grade II. In the patients submitted to 24-hour pH-monitoring, a greater number or reflux episodes in orthostatic position than in supine position (P < 0.0001) was observed. The total number of reflux episodes, the most prolonged reflux and the total pH time < 4 were statistically higher in post-prandial period than during meals (P = 0.005).
Navarro-Rodriguez
T
T
Department of Gastroenterology, Medical School, University of São Paulo, Brazil.
de Moraes-Filho
J P
JP
Arakaki
E
E
Chinzon
D
D
Zaterka
S
S
Iriya
K
K
Laudanna
A A
AA
D000293:Adolescent; D000328:Adult; D000368:Aged; D016145:Endoscopy, Digestive System; D004941:Esophagitis / Q000175:diagnosis*; D005260:Female; D005744:Gastric Acid; D005764:Gastroesophageal Reflux; D006356:Heartburn / Q000175:diagnosis*; D006801:Humans; D006863:Hydrogen-Ion Concentration; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic; D010477:Perfusion; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D013997:Time Factors