Symptom priority ranking in the care of gastroesophageal reflux

A review of 1,850 cases

Tomas Martinez-Serna, Francisco Tercero, Charles Filipi, Timothy J. Dickason, Patrice Watson, Sumeet K. Mittal, Mark R. Tasset

Research output: Contribution to journalArticle

15 Citations (Scopus)

Abstract

Background: Clinical history remains an important part of the medical evaluation of patients with gastroesophageal reflux disease (GERD). Heartburn, regurgitation, and dysphagia are considered typical symptoms of GERD. Priority rankings of these symptoms can be determined with a standardized questionnaire. Objective: To determine whether symptom priority ranking and symptom severity grading can provide useful information in the evaluation of patients with GERD. Methods: From 1,850 patients that were analyzed retrospectively, patients with dysphagia unrelated to GERD were excluded. A standardized questionnaire was applied before each patient underwent any esophageal diagnostic study. Priority of symptoms was determined to be primary, secondary, tertiary, or none based on the patient response to the questionnaire. Presence of a stricture was determined either by endoscopy, esophagraphy, or both studies. Stationary esophageal manometry and 24-hour pH monitoring were performed on all patients. Through bivariate and multivariate analysis, the relationships among typical GERD symptoms, esophageal reflux-related stenosis, lower esophageal sphincter pressure, and composite score were established. Results: High priority ranking of the symptom dysphagia is predictive of the presence of an esophageal stricture, but has a negative association with abnormal manometric and pH studies. In contrast, high priority ranking of the symptom heartburn and regurgitation are positively associated with abnormal manometric and pH results. Conclusions: Priority ranking can be a valuable adjunct to objective testing in the evaluation of GERD. In certain clinical situations it can obviate the need for 24-hour pH monitoring. Copyright (C) 2000 S. Karger AG, Basel.

Original languageEnglish
Pages (from-to)219-224
Number of pages6
JournalDigestive Diseases
Volume17
Issue number4
StatePublished - 1999

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Gastroesophageal Reflux
Deglutition Disorders
Heartburn
Pathologic Constriction
Esophageal Stenosis
Lower Esophageal Sphincter
Manometry
Endoscopy
Multivariate Analysis
Pressure
Surveys and Questionnaires

All Science Journal Classification (ASJC) codes

  • Gastroenterology

Cite this

Martinez-Serna, T., Tercero, F., Filipi, C., Dickason, T. J., Watson, P., Mittal, S. K., & Tasset, M. R. (1999). Symptom priority ranking in the care of gastroesophageal reflux: A review of 1,850 cases. Digestive Diseases, 17(4), 219-224.

Symptom priority ranking in the care of gastroesophageal reflux : A review of 1,850 cases. / Martinez-Serna, Tomas; Tercero, Francisco; Filipi, Charles; Dickason, Timothy J.; Watson, Patrice; Mittal, Sumeet K.; Tasset, Mark R.

In: Digestive Diseases, Vol. 17, No. 4, 1999, p. 219-224.

Research output: Contribution to journalArticle

Martinez-Serna, T, Tercero, F, Filipi, C, Dickason, TJ, Watson, P, Mittal, SK & Tasset, MR 1999, 'Symptom priority ranking in the care of gastroesophageal reflux: A review of 1,850 cases', Digestive Diseases, vol. 17, no. 4, pp. 219-224.
Martinez-Serna T, Tercero F, Filipi C, Dickason TJ, Watson P, Mittal SK et al. Symptom priority ranking in the care of gastroesophageal reflux: A review of 1,850 cases. Digestive Diseases. 1999;17(4):219-224.
Martinez-Serna, Tomas ; Tercero, Francisco ; Filipi, Charles ; Dickason, Timothy J. ; Watson, Patrice ; Mittal, Sumeet K. ; Tasset, Mark R. / Symptom priority ranking in the care of gastroesophageal reflux : A review of 1,850 cases. In: Digestive Diseases. 1999 ; Vol. 17, No. 4. pp. 219-224.
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