24-hour pH monitoring in symptomatic patients without erosive esophagitis who did not respond to antireflux treatment.

Abstract

Twenty symptomatic patients without erosive esophagitis underwent 24-h esophageal pH monitoring after failing standard medical antireflux treatment. Sixty-five percent had abnormal esophageal acid exposure, and the majority of these improved on proton pump inhibitor therapy. However, 35% had a normal 24-h pH test. One patient had coronary artery disease, one had diffuse esophageal spasm, and two had a negative work-up and no improvement with omeprazole. Consequently, we suggest that patients like these have an omeprazole trial. If symptoms persist, 24-h esophageal pH monitoring can appropriately define more rational management. Patients with abnormal esophageal acid exposure will require more aggressive acid-control therapy, whereas those with normal esophageal acid exposure will need further work-up to assess the cause of their symptoms.

• Authors: R Fass, C Mackel, R E Sampliner
• Journal: Journal of clinical gastroenterology (J Clin Gastroenterol) Vol. 19 Issue 2 Pg. 97-9 (Sep 1994) ISSN: 0192-0790 [Print] United States
• PMID: 7963375 (Publication Type: Journal Article)

Chemical References

• Anti-Ulcer Agents
• Proton Pump Inhibitors
• Omeprazole

Topics

• Adult
• Aged
• Aged, 80 and over
• Anti-Ulcer Agents (therapeutic use)
• Esophagitis
• Esophagus (metabolism)
• Female
• Gastroesophageal Reflux (drug therapy, physiopathology)
• Humans
• Hydrogen-Ion Concentration
• Male
• Middle Aged
• Monitoring, Ambulatory
• Omeprazole (therapeutic use)
• Prospective Studies
• Proton Pump Inhibitors
• Treatment Failure