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Kyoung Soo Lee, Na Young Kim, Ran Young Park, Chung Hyun Kim, Hyun Young Kim, Young Soo Park, Jin Hyok Hwang, Jin Wook Kim, Dong Ho Lee, Hyun Chae Jung, In Sun |
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Department of Internal Medicine, Hanyang University College of Medicine |
| 원저 : 위식도역류질환 진단 및 임상양상에 있어서 내시경, 24시간 식도 산도검사, Bernstein 검사의 역할 및 증상과의 관계 (Original Articles : The role of endoscopy, 24 hour ambulatory esophageal pH monitor and bernst |
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이경수, 김나영, 박란영, 김충현, 김현영, 박영수, 황진혁, 김진욱, 이동호, 정현채, 송인성 |
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| Abstract |
Background : The aim of this study is to evaluate the diagnostic usefulness of endoscopy, 24
hour esophageal pH monitor and Bernstein test for GERD and its relationship with GERD symptom
in the presence or absence of reflux esophagitis (RE).
Methods
: This study was performed for 168 patients with GERD. Clinical symptoms and the
results
of endoscopy, 24 hour esophageal pH monitor, esophageal manometry with Bernstein test
were analyzed.
Results
: 168 (42%) of 403 patients who complained symptoms suggestive of GERD were
diagnosed as GERD (65% as RE, 35% as nonerosive reflux disease) using diagnostic tools for GERD.
The most chief complaint symptoms were heartburn (18.5%), regurgitation (18.5%), noncardiac chest
pain (10.7%), cough (10.7%), laryngeal symptoms (11.3%), non specific dyspepsia (24.4%) and others
(6%). When comparison of symptoms depending on RE among GERD patients was performed,
laryngeal symptoms were significantly more frequent in patients without RE (p=0.001), and dyspepsia
in patients with RE (p<0.001), respectively. Regarding diagnostic efficacy of each test depending on
symptom, patients with heartburn showed higher positive rate of Bernstein test (p=0.035) and
patients with laryngeal symptoms showed higher positive rate of 24 hour esophageal pH monitor
(p=0.015), respectively. In addition, there was no correlation among endoscopy, 24 hour esophageal
pH monitor and Bernstein test in the diagnosis of GERD by Kappa index.Conclusions : Typical reflux symptoms of GERD such as heartburn and regurgitation were
found in 37% of GERD patients in Korea, lower than in Western countries. The lack of correlation
among the diagnostic tools for GERD suggests that these tools are complementary to each other for
the diagnosis of GERD.(Korean J Med 70:145-156, 2006)
Key Words : Gastroesophageal reflux disease, Esophagitis, Reflux |
| Key Words:
Gastroesophageal reflux disease, Esophagitis, Reflux |
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