The Pattern of Gastroesophageal Reflux in Patients with Gastroesophageal Reflux Disease

Jang, Theresa; Kim, Baek Sun; Kim, Sun Myung; Choo, Kyo Young; Oh, Jung Hwan; Hyun, Young Geun; Park, Soo Heon; Choi, Myung Gyu; Han, Jun Yeol; Kim, Jae Kwang; Chung, In Sik; Chung, Kyu Won; Sun, Hee Sik

Abstract

BACKGROUND/AIMS: Generally, it is recommended for patients with gastroesophageal reflux disease to sleep with the head of the bed elevated; however, many patients in Korea do not have heartburn symptoms during the night.
METHODS
We investigated the pattern of acid reflux in patients who were diagnosed as having definite pathological acid reflux on 24-hour pH monitoring.
RESULTS
One hundred patients were categorized into 3 groups; upright refluxer (68%), supine refluxer (2%), or combined refluxer (30%). Acid reflux was rare in supine positions but instead, usually occurred in upright positions. Acid reflux was found to occur most commonly after meals. The reflux symptoms occurred during pH monitoring with the average frequency of 5.5 times (total of 254 times) in 46 patients. The acid related symptoms were more common in the upright period and postprandially than the supine period. The presence of an esophagitis, an esophageal motility disorder, or the LES pressure did not make a significant difference between upright refluxer and supine refluxer.
CONCLUSIONS
Gastroesophageal reflux was found to be rare in supine positions but usually occurred in upright positions. Gastroesophageal reflux occurred most commonly after meals, and was frequently associated with reflux symptoms.