title: The value of ambulatory 24 hr esophageal pH monitoring in clinical practice in patients who were referred with persistent gastroesophageal reflux disease (GERD)-related symptoms while on standard dose anti-reflux medications.
abstract: To determine the value of pH testing in clinical practice in gastroesophageal reflux disease patients who failed anti-reflux treatment. Patients resistant to standard dose proton pump inhibitor or an H2-blocker underwent pH testing. Randomly selected patients from the proton pump inhibitor failure group underwent the modified acid perfusion test as compared to patients with non-erosive reflux disease. In the proton pump inhibitor failure group (n = 70), 63.8% had a normal pH test as compared to 29% in the H2-blocker group (n = 31) (P = 0.007). Sensory intensity rating and acid perfusion sensitivity score were significantly higher in the non-erosive reflux disease control group than the proton pump inhibitor failure group (P < 0.05). Most patients who continued to be symptomatic on proton pump inhibitor once daily demonstrated a normal pH test and overall lack of increased chemoreceptor sensitivity to acid.
authors.affiliation: Department of Medicine, The Neuro-Enteric Clinical Research Group, Section of Gastroenterology, Southern Arizona VA Health Care System, University of Arizona College of Medicine, Tucson, Arizona 85723-0001, USA.
authors.forename: Jimmy M
authors.initials: JM
authors.lastname: Bautista
authors.forename: Wai-Man
authors.initials: WM
authors.lastname: Wong
authors.forename: Gloria
authors.initials: G
authors.lastname: Pulliam
authors.forename: Romeo F
authors.initials: RF
authors.lastname: Esquivel
authors.forename: Ronnie
authors.initials: R
authors.lastname: Fass
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004947:Esophagus / Q000503:physiopathology*; D005260:Female; D005764:Gastroesophageal Reflux / Q000150:complications / Q000188:drug therapy* / Q000503:physiopathology*; D006356:Heartburn / Q000188:drug therapy / Q000209:etiology / Q000503:physiopathology; D006635:Histamine H2 Antagonists / Q000627:therapeutic use*; D006801:Humans; D006863:Hydrogen-Ion Concentration; D008297:Male; D008875:Middle Aged; D018670:Monitoring, Ambulatory; D017494:Proton Pumps / Q000627:therapeutic use*; D012017:Referral and Consultation; D015203:Reproducibility of Results; D017211:Treatment Failure
chemical_list: D006635:Histamine H2 Antagonists; D017494:Proton Pumps