GERD questionnaire for diagnosis of gastroesophageal reflux disease in systemic sclerosis.
OBJECTIVE
Gastroesophageal reflux disease (GERD) is clinically-identified in patients with systemic sclerosis (SSc). The GERD-questionnaire (GERD-Q) score is a sensitive, non-invasive, diagnostic screening tool for diagnosis of GERD in general patients, but it has been not investigated for use in SSc. Our aim was to evaluate the proper cut-off GERD-Q score, sensitivity and specificity for a diagnosis of GERD in SSc patients.


METHODS
A cross-sectional study using the GERD-Q was performed during May 2012-January 2013 on patients over 18 with the diffuse SSc subset. Both esophago-gastro-duodenoscopy (EGD) and 24-hr pH-monitoring (24hr-pH) were performed as the gold standard tests for both symptomatic and asymptomatic GERD.


RESULTS
A total of 75 SSc patients completed the GERD-Q, EGD and 24hr-pH. We identified 22 males (29.3%), 53 females (70.7%) with a mean age of 54.2 years. The respective number of symptomatic and asymptomatic GERD was 69 and 6 cases. For a GERD diagnosis, a cut-off GERD-Q score of 4 provided the best balance between sensitivity and specificity (96.9% and 50%, respectively). Of 48 participants (69.6%) with symptomatic GERD (i.e. positive for both EGD and 24hr-pH), 65 (94.2%) were positive for either EGD or 24hr-pH, and 4 (5.8%) were negative for both EGD and 24hr-pH. A respective majority (83%) vs. one-third of the asymptomatic group had reflux as detected by 24hr-pH vs.
A GERD-Q score of 4 or higher indicates a high sensitivity for a diagnosis of GERD in SSc. It can thus be used as a non-invasive screening tool for diagnosing GERD in cases where EGD and 24hr-pH are unavailable.
Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand. kitti@kku.ac.th.
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K
Chunlertrith
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A
Noiprasit
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Foocharoen
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P
Mairiang
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W
Sukeepaisarnjaroen
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Sangchan
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Sawadpanitch
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D016145:Endoscopy, Digestive System; D004947:Esophagus / Q000473:pathology*; D005260:Female; D005764:Gastroesophageal Reflux / Q000175:diagnosis* / Q000209:etiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D012595:Scleroderma, Systemic / Q000150:complications / Q000175:diagnosis*; D012680:Sensitivity and Specificity; D011795:Surveys and Questionnaires