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J Clin Gastroenterol. 1994 Sep;19(2):97-9.

24-hour pH monitoring in symptomatic patients without erosive esophagitis who did not respond to antireflux treatment.

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University of Arizona Health Sciences Center, Tucson.


Twenty symptomatic patients without erosive esophagitis underwent 24-h esophageal pH monitoring after failing standard medical antireflux treatment. Sixty-five percent had abnormal esophageal acid exposure, and the majority of these improved on proton pump inhibitor therapy. However, 35% had a normal 24-h pH test. One patient had coronary artery disease, one had diffuse esophageal spasm, and two had a negative work-up and no improvement with omeprazole. Consequently, we suggest that patients like these have an omeprazole trial. If symptoms persist, 24-h esophageal pH monitoring can appropriately define more rational management. Patients with abnormal esophageal acid exposure will require more aggressive acid-control therapy, whereas those with normal esophageal acid exposure will need further work-up to assess the cause of their symptoms.

[Indexed for MEDLINE]

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