Significance of Parameters of 24 Hour Ambulatory Esophageal pHmetry and Bernstein Test for Diagnosis of Gastroesophagela Reflux

Park, Soong Kook; Kim, Kwon Bae; Kang, Young Woo; Huh, Kyu Chan; Chung, Woo Jin; Youn, Young Ho; Kim, Kee Sik; Kim, Yoon Nyun; Hwang, Jae Seok

Abstract

BACKGROUND AND AIMS: We carried out this study to adapt various positive parameters of 24 hour pHmetry for diagnosis of gastroesophageal reflux disease and to determine a correlation between Bernstein test and 24 hour pHmetry.
METHODS
Sixty-six patients who complained of non-cardiac chest pain underwent Bernstein test and 24 hour pHrnetry. We defined the positive parameters of 24 hour pHmetry as the time percentage of esophageal pH below 4, above 5.78% or 11%, DeMeester score ahove 14,7, symptom index, above 25% or 50%, symptom sensitivity index above 5%. We compared the results of Bernstein test with those of 24 hour pHmetry.
RESULTS
On esophageal 24 hour pHmetry, the number of the patients who showed the time percentage of esophageal pH below 4 above 5.78% was 9 (13.6%), above 11% was 4 (6.1%). DeMeester score above 14.7 was seen in 10 (15.2%). Symptom index above 25% was seen in 9 (13.6%), above 50% in 4 (6.1%). Symptom sensitivity index above 5% was observed in 5 (7.6%). Total positive rate was 24.2%-27.2%. On Bemstein test, positive rate was 50%. Ten to twelve patients (30.3%-36.4%) out of 33 patients who were positive for Bernstein test showed positive esophageal 24 hour pHmetry. Six patients out of 33 patients who were negative for Bernstein test showed positive esophageal 24 hour pHmetry. There was no conelation between 24 hour pHmetry and Bernstein test using a kappa index.
CONCLUSIONS
The positive rate of 24 hour pHmetry for Korean people was lower than that of western people and there was no correlation between Bernstein test and 24 hour pHmetry, We think further investigation should be conducted to confirm the positive parameters of 24 hour pHmetry.