The Incidence of Gastroesophageal Reflux Disease and the Effect of Cisapride in Patients with Epigastric Soreness

Kim, Yun Bae; Song, Chi Wook; Kim, Hye Rang; Lee, Sang Woo; Bak, Young Tae; Hyun, Jin Hai; Moon, Jeong Seop; Park, Hyun Chul

Abstract

BACKROUND/AIMS: It has been thought that in many of those who complain of "epigastric soreness," their symptom is actually "heartburn" secondary to gastroesophageal reflux disease (GERD). This study was undertaken to determine the incidence of GERD in patients who complain of epigastric soreness and to evaluate the effect of cisapride tartrate on their symptoms.
METHODS
A total 107 patients who visited tertiary referral hospitals and complained of epigastric soreness were enrolled. We evaluated their symptoms and performed esophagogastroduodenoscopies (EGD). In 53 of the 107 patients who showed a normal EGD, gastroesophageal reflux studies (24 hour ambulatory pH monitoring, Bernstein test, modified Bernstein test) were performed.
RESULTS
Of the 107 patients, 36 had organic gastroduodenal diseases, 18 had reflux esophagitis, and 53 showed a normal EGD finding. Of these 53 patients, the gastroesophageal reflux studies were normal in 23 patients and abnormal in 30. Forty eight (44.9%) of 107 patients showed reflux-associated epigastric soreness. There was no difference in demographic characteristics among reflux-associated, gastroduodenal, and functional epigastric soreness groups. Among clinical characteristics of the 3 groups, the only difference found was the time of the symptoms during a day. In the reflux-associated epigastric soreness group, the symptoms were more severe during daytime. After cisapride tartrate administration for 4 weeks, symptom scores of reflux-associated and functional epigastric soreness groups improved from 9.2+/-3.9 and 10.4+/-3.9 to 4.0+/-3.8 and 3.8+/-2.2, respectively.
CONCLUSIONS
We found a great number of patients having GERD among those complaining of "epigastric soreness." Cisapride tartrate was effective in relieving epigastric soreness in reflux-associated and functional epigastric soreness groups.