Symptom Priority Ranking in the Care of Gastroesophageal Reflux: A Review of 1,850 Cases
| Autor: | Charles J. Filipi, Tomas Martinez-Serna, Timothy J. Dickason, Francisco Tercero, Mark R. Tasset, Sumeet K. Mittal, Patrice Watson |
|---|---|
| Rok vydání: | 1999 |
| Předmět: |
Adult
Male medicine.medical_specialty Manometry Disease Risk Assessment Severity of Illness Index Predictive Value of Tests Severity of illness otorhinolaryngologic diseases Humans Medicine Registries Intensive care medicine Esophagitis Peptic Aged business.industry General surgery digestive oral and skin physiology Gastroenterology Reflux Reproducibility of Results Heartburn General Medicine Hydrogen-Ion Concentration Middle Aged medicine.disease Dysphagia humanities digestive system diseases Predictive value of tests Multivariate Analysis Regurgitation (digestion) Esophageal Stenosis Gastroesophageal Reflux GERD Regression Analysis Female Esophagoscopy medicine.symptom business |
| Zdroj: | Digestive Diseases. 17:219-224 |
| ISSN: | 1421-9875 0257-2753 |
| Popis: | 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. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|