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- Title
Accuracy of diagnosing gastroesophageal reflux disease by GerdQ, esophageal impedance monitoring and histology.
- Authors
Zhou, Li Ya; Wang, Ye; Lu, Jing Jing; Lin, Lin; Cui, Rong Li; Zhang, He Jun; Xue, Yan; Ding, Shi Gang; Lin, San Ren
- 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.
- Subjects
GASTROESOPHAGEAL reflux; EPITHELIAL cells; ENDOSCOPY; PH effect; ESOMEPRAZOLE
- Publication
Journal of Digestive Diseases, 2014, Vol 15, Issue 5, p230
- ISSN
1751-2972
- Publication type
Article
- DOI
10.1111/1751-2980.12135