title: Accuracy of diagnosing gastroesophageal reflux disease by GerdQ, esophageal impedance monitoring and histology.
abstract: OBJECTIVE
  To assess the performance of self-assessment gastroesophageal reflux disease questionnaire (GerdQ), 24-h impedance monitoring, proton pump inhibitor (PPI) test and intercellular space of esophageal mucosal epithelial cells in the diagnosis of gastroesophageal reflux disease (GERD).
  
  
  METHODS
  Patients with symptoms suspected of GERD were administered the GerdQ and underwent endoscopy (measurement of intercellular space in the biopsy specimen sampling at 2 cm above the Z-line) and 24-h impedance pH monitoring, together with a 2-week experimental treatment with esomeprazole.
  
  
  RESULTS
  A total of 636 patients were included for the final analysis, including 352 with GERD. The sensitivity and specificity of GerdQ and 24-h impedance monitoring for diagnosing GERD were 57.7% and 48.9%, and 66.4% and 43.3%, respectively. The sensitivity of 24-h impedance pH monitoring increased to 93.7%. The sensitivity and specificity of dilated intercellular spaces (DIS) (≥0.9 μm) for diagnosing GERD were 61.2% and 56.1%, respectively, whereas those for PPI test were 70.5% and 44.4%.
  
  
  CONCLUSIONS
  GerdQ score or PPI test alone cannot accurately diagnose GERD in a Chinese population suspected of GERD. A definitive diagnosis of GERD still depends on endoscopy or 24-h pH monitoring. 24-h impedance pH monitoring may increase the sensitivity for diagnosing GERD by 20%; however, when used alone, it results in poor specificity in patients without acid suppressive therapy.
authors: Department of Gastroenterology, Peking University Third Hospital, Beijing, China.
authors: Li Ya
authors: LY
authors: Zhou
authors: Ye
authors: Y
authors: Wang
authors: Jing Jing
authors: JJ
authors: Lu
authors: Lin
authors: L
authors: Lin
authors: Rong Li
authors: RL
authors: Cui
authors: He Jun
authors: HJ
authors: Zhang
authors: Yan
authors: Y
authors: Xue
authors: Shi Gang
authors: SG
authors: Ding
authors: San Ren
authors: SR
authors: Lin
mesh_terms: D000328:Adult; D000897:Anti-Ulcer Agents / Q000627:therapeutic use; D044466:Asian People; D001706:Biopsy; D017097:Electric Impedance; D020776:Endoscopes, Gastrointestinal / Q000592:standards*; D064098:Esomeprazole / Q000627:therapeutic use*; D050782:Esophageal pH Monitoring / Q000592:standards*; D004947:Esophagus / Q000473:pathology; D005260:Female; D005764:Gastroesophageal Reflux / Q000188:drug therapy* / Q000473:pathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009092:Mucous Membrane / Q000473:pathology; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D011795:Surveys and Questionnaires / Q000592:standards*
chemical_list: D000897:Anti-Ulcer Agents; D064098:Esomeprazole
keywords: gastroesophageal reflux disease; gastroesophageal reflux disease questionnaire; impedance; intercellular space