title: The usefulness of a structured questionnaire in the assessment of symptomatic gastroesophageal reflux disease.
abstract: BACKGROUND
  The diagnosis of gastroesophageal reflux disease (GERD) rests primarily on recognition of symptom patterns that are classical for reflux disease, but little attention has been paid to the use of a formal questionnaire for identifying such symptom patterns.
  
  
  METHODS
  A self-administered questionnaire was developed which has seven items that focus on the nature of the symptoms and the precipitating, exacerbating, and relieving factors. The diagnostic validity of the questionnaire was tested against endoscopy and 24-h pH monitoring. A further evaluation was undertaken in patients with symptoms suggestive of GERD and in patients with non-ulcer dyspepsia, to identify factors that might predict symptom relief during treatment with omeprazole.
  
  
  RESULTS
  When endoscopic esophageal mucosal breaks and 24-h pH data were used as criteria for the diagnosis of GERD, the questionnaire had a sensitivity of 92% but a very low specificity of 19%. Symptom relief during treatment with omeprazole was predicted by the presence of heartburn, described as 'a burning feeling rising from the stomach or lower chest up towards the neck' (P = 0.004), and 'relief from antacids' (P = 0.02). In non-ulcer dyspepsia a positive response to omeprazole was confined to the subgroup of patients who identified their main discomfort as heartburn as described above.
  
  
  CONCLUSIONS
  The present questionnaire using descriptive language usefully identified heartburn in patients presenting with upper abdominal symptoms, and this symptom predicted symptom resolution during treatment with omeprazole.
authors.affiliation: Dept. of Surgery, Sahlgren's University Hospital, Göteborg, Sweden.
authors.forename: R
authors.initials: R
authors.lastname: Carlsson
authors.forename: J
authors.initials: J
authors.lastname: Dent
authors.forename: E
authors.initials: E
authors.lastname: Bolling-Sternevald
authors.forename: F
authors.initials: F
authors.lastname: Johnsson
authors.forename: O
authors.initials: O
authors.lastname: Junghard
authors.forename: K
authors.initials: K
authors.lastname: Lauritsen
authors.forename: S
authors.initials: S
authors.lastname: Riley
authors.forename: L
authors.initials: L
authors.lastname: Lundell
mesh_terms: D000897:Anti-Ulcer Agents / Q000627:therapeutic use; D004415:Dyspepsia / Q000175:diagnosis; D016145:Endoscopy, Digestive System; D004942:Esophagitis, Peptic / Q000175:diagnosis / Q000453:epidemiology; D005745:Gastric Acidity Determination; D005764:Gastroesophageal Reflux / Q000175:diagnosis* / Q000188:drug therapy / Q000453:epidemiology; D006356:Heartburn / Q000175:diagnosis / Q000453:epidemiology; D006801:Humans; D018670:Monitoring, Ambulatory; D009853:Omeprazole / Q000627:therapeutic use; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity; D011795:Surveys and Questionnaires
chemical_list: D000897:Anti-Ulcer Agents; D009853:Omeprazole