THE SYMPTOM INDEX - A CLINICALLY IMPORTANT PARAMETER OF AMBULATORY 24-HOUR ESOPHAGEAL PH MONITORING

  • 1 April 1988
    • journal article
    • research article
    • Vol. 83  (4) , 358-361
Abstract
Ambulatory 24-h esophageal pH monitoring is an accurate quantitative test of gastroesophageal reflux (GER). However, it does not answer the question: are the patients'' symptoms due to GER? We developed a numerical scale to quantify the percent association between symptoms and pH < 4-the symptom index (SI). In 100 consecutive patients with heartburn or chest pain, the SI for the chief complaint ws either high (> 75%) or low (< 25%) in 77% of cases. A similar bimodal distribution was seen when heartburn or chest pain symptoms were individually evaluated. There was a good association between high SI and the presence of GER (97.5%), as well as low SI and a normal 24-h pH study (81.1%). Endoscopy was normal in 89.5% of patients with low SI, but patients with high SI had esophagitis in only 69.7% of cases. The Bernstein test showed a poor association with the SI. Therefore, the SI gives clinically relevant information regarding the role of acid reflux and patient''s symptoms. We believe this simple calculated index should be included in the analysis of 24-h esophageal pH studies.

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