Heartburn severity can predict pathologic oesophageal reflux in gastro-oesophageal reflux disease patients treated with a proton-pump inhibitor
Article first published online: 7 JUL 2003
Alimentary Pharmacology & Therapeutics
Volume 18, Issue 1, pages 133–140, July 2003
How to Cite
Gardner, J. D., Sloan, S., Robinson, M. and Miner, P. B. (2003), Heartburn severity can predict pathologic oesophageal reflux in gastro-oesophageal reflux disease patients treated with a proton-pump inhibitor. Alimentary Pharmacology & Therapeutics, 18: 133–140. doi: 10.1046/j.1365-2036.2003.01644.x
- Issue published online: 7 JUL 2003
- Article first published online: 7 JUL 2003
- Accepted for publication 24 April 2003
Background : In gastro-oesophageal reflux disease (GERD) subjects treated with a gastric anti-secretory agent, it is not known whether there is a relationship between heartburn severity and oesophageal acid exposure.
Methods : Oesophageal pH and heartburn severity were determined in 27 GERD subjects at baseline and on days 1, 2 and 8 of treatment with 20 mg omeprazole or 20 mg rabeprazole in a randomized, two-way crossover fashion.
Results : Receiver operating characteristic (ROC) analysis was used to determine values for heartburn severity that gave optimal cut-off points for distinguishing between normal and pathologic oesophageal reflux. Using these cut-off points, we found that the probability of no pathologic oesophageal reflux (Y) could be best fitted by an exponential equation: Y = a(e–bX) + c, where a, b and c are constants and X is the value of heartburn severity. There was close agreement between predicted and observed percentages of subjects with pathologic oesophageal reflux during different days of treatment.
Conclusions : In GERD subjects treated with a proton-pump inhibitor, the value of heartburn severity following a single standard meal can predict the likelihood of pathologic oesophageal reflux over the entire 24-h period.