title: [Factors related to the presence of reflux in patients with typical symptoms of gastroesophageal reflux disease (GERD)].
abstract: OBJECTIVE
  To analyze clinical, abdominal ultrasound, upper digestive endoscopic, esophageal manometric and prolonged esophageal pH-monitoring findings in patients with typical symptoms of GERD.
  
  
  METHODS
  The study included a total of 251 patients with typical GERD symptoms. Clinical data, Body Mass Index, abdominal ultrasound aspects and upper digestive endoscopic data are reported. Manometry and esophageal pH-monitoring were performed.
  
  
  RESULTS
  One-hundred-and-seventy-two patients were female (68.5%). Mean age of the total was 51.8 years. Ultrasound examination revealed colelithiasis in 23 patients and PC in 21 patients. Hiatal hernia was diagnosed in 177 patients (71%), with an average size of 3.0 cm. Erosive esophagitis was found in 168 patients (66.9%) and Barrett's esophagus in 23 patients (9.2%). A combination of hiatal hernia and esophagitis was diagnosed in 131 patients (52.3%) while only 37 patients (14.7%) did not present either. The mean extension of the lower esophageal sphincter (LES) was 2.6 cm, whereas in 132 patients (52.6%) the LES was shorter. The mean pressure of the LES was 18.9 mmHg; 46 patients (18.3%) had pressures below 14 mmHg. The mean number of reflux episodes on prolonged esophageal monitoring was 42.9; the mean number of prolonged episodes of reflux was 4.6, and the mean percentage of total acid time was 8.4%. DeMeester scores were high in 175 patients (69.7%).
  
  
  CONCLUSIONS
  In patients with typical GERD symptoms, factors influencing the presence of pathological reflux as confirmed by prolonged esophageal pH-monitoring were: age, hiatal hernia associated to erosive esophagitis, a smaller extension, low baseline pressure and smaller volume vector of the LES.
authors.affiliation: Grupo de Afecções do Esôfago, Departamento de Cirurgia, Faculdade de Ciências Médicas, Santa Casa de São Paulo, SP. r.corsi@terra.com.br
authors.forename: Paulo Roberto
authors.initials: PR
authors.lastname: Corsi
authors.forename: Danilo
authors.initials: D
authors.lastname: Gagliardi
authors.forename: Mozar
authors.initials: M
authors.lastname: Horn
authors.forename: Celso de Castro
authors.initials: Cde C
authors.lastname: Pochini
authors.forename: Reinaldo Martins de
authors.initials: RM
authors.lastname: Oliveira Neto
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004941:Esophagitis / Q000150:complications; D004945:Esophagoscopy; D005260:Female; D005764:Gastroesophageal Reflux / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology*; D006551:Hernia, Hiatal / Q000150:complications; D006801:Humans; D006863:Hydrogen-Ion Concentration; D008297:Male; D008365:Manometry; D008875:Middle Aged