A prospective study of oesophageal 24-h ambulatory pH monitoring in patients with functional dyspepsia.
BACKGROUND
The diagnostic utility of 24-h oesophageal ambulatory pH monitoring in patients with functional dyspepsia has not been well established.


OBJECTIVE
We performed a prospective study of oesophageal pH monitoring in patients with functional dyspepsia in order to assess whether a positive pH test might predict response to proton pump inhibitor therapy in a subset of functional dyspepsia patients.


METHODS
Forty Helicobacter pylori-negative functional dyspepsia patients (35 males and 5 females, mean age (+/-S.E.M.) of 54+/-2.4 years) with predominantly unspecified dyspepsia subtype and normal distal oesophageal biopsies.


METHODS
All subjects were randomised in a double-blind fashion to either omeprazole 20 mg/day or placebo daily for four weeks after 24-h pH monitoring.


RESULTS
Twenty-four-hour pH monitoring was abnormal in 9 of the 21 patients (43%) in the omeprazole group and 5/19 (26%) of the placebo group (p=NS). Patients who reported symptomatic improvement on the Gastrointestinal Symptom Rating Scale were no more likely to have abnormal scores on pH monitoring than patients who did not have symptomatic response.


CONCLUSIONS
Although approximately one-third of functional dyspepsia patients will have abnormal profiles on 24-h ambulatory oesophageal pH monitoring, an abnormal score does not appear to predict response to proton pump inhibitor therapy in patients with unspecified functional dyspepsia.
Gerson
L B
LB
Division of Gastroenterology and Hepatology, A 149, Stanford University School of Medicine, Stanford University, Stanford, CA 94305-5202, USA. lgerson@stanford.edu
Triadafilopoulos
G
G
D000897:Anti-Ulcer Agents / Q000627:therapeutic use; D004311:Double-Blind Method; D004415:Dyspepsia / Q000188:drug therapy / Q000503:physiopathology*; D004947:Esophagus / Q000503:physiopathology*; D005260:Female; D006801:Humans; D006863:Hydrogen-Ion Concentration; D008297:Male; D008875:Middle Aged; D018670:Monitoring, Ambulatory; D008991:Monitoring, Physiologic; D009853:Omeprazole / Q000627:therapeutic use; D011446:Prospective Studies; D016896:Treatment Outcome
D000897:Anti-Ulcer Agents; D009853:Omeprazole