Juice test for identification of nonerosive reflux disease in heartburn patients
Autor(a) principal: | |
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Data de Publicação: | 2018 |
Outros Autores: | , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Repositório Institucional da UFRGS |
Texto Completo: | http://hdl.handle.net/10183/180058 |
Resumo: | Background/Aims Evaluation of esophageal clearance by orange juice swallowing could be useful to identify different categories of gastroesophageal reflux disease. We determined whether a juice test at the beginning of esophageal pH monitoring can identify nonerosive reflux disease (NERD) among heartburn patients. Methods Multiple swallows of orange juice (pH 3) were performed at the beginning of esophageal pH monitoring in 71 heartburn patients off acid-suppressive therapy. The area between pH drop below 5 and recovery to 5 was calculated from pH tracings and named Delta5 (mmol∙L-1∙sec). Fifteen healthy subjects served to determine Delta5 cutoff (95th percentile). Patients were classified as NERD, non- NERD (a mix of reflux hypersensitivity, functional heartburn, and undetermined), and erosive disease depending on acid exposure, reflux symptom analysis, and upper endoscopy. Results Delta5 cutoff in healthy subjects was 251 mmol·L-1∙sec. Among 71 patients, 23 had NERD, 26 had non-NERD, and 22 had erosive disease. Compared to non-NERD, Delta5 was higher in both NERD (median [interquartile range]: 316 [213-472] vs 165 [105-225]; P < 0.01) and erosive disease (310 [169-625] vs 165 [105-225]; P < 0.01). An elevated Delta5 (> 251 mmol∙L-1∙sec) showed sensitivity of 74% and specificity of 81% for identification of NERD. Positive and negative likelihood ratios were 3.84 and 0.32 respectively, whereas test accuracy was 78%. Conclusions A juice test with calculation of Delta5 helps in the identification of true NERD among heartburn patients with endoscopy-negative reflux disease. In these patients, an elevated Delta5 could make prolonged reflux testing unnecessary. (J Neurogastroenterol Motil 2018;24:233-240) |
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Fernandes, Michel RibeiroOliveira, Marina deCallegari-Jacques, Sidia MariaGonçalves, Gissele Vargas da RosaFornari, Fernando2018-07-04T02:26:59Z20182093-0887http://hdl.handle.net/10183/180058001068252Background/Aims Evaluation of esophageal clearance by orange juice swallowing could be useful to identify different categories of gastroesophageal reflux disease. We determined whether a juice test at the beginning of esophageal pH monitoring can identify nonerosive reflux disease (NERD) among heartburn patients. Methods Multiple swallows of orange juice (pH 3) were performed at the beginning of esophageal pH monitoring in 71 heartburn patients off acid-suppressive therapy. The area between pH drop below 5 and recovery to 5 was calculated from pH tracings and named Delta5 (mmol∙L-1∙sec). Fifteen healthy subjects served to determine Delta5 cutoff (95th percentile). Patients were classified as NERD, non- NERD (a mix of reflux hypersensitivity, functional heartburn, and undetermined), and erosive disease depending on acid exposure, reflux symptom analysis, and upper endoscopy. Results Delta5 cutoff in healthy subjects was 251 mmol·L-1∙sec. Among 71 patients, 23 had NERD, 26 had non-NERD, and 22 had erosive disease. Compared to non-NERD, Delta5 was higher in both NERD (median [interquartile range]: 316 [213-472] vs 165 [105-225]; P < 0.01) and erosive disease (310 [169-625] vs 165 [105-225]; P < 0.01). An elevated Delta5 (> 251 mmol∙L-1∙sec) showed sensitivity of 74% and specificity of 81% for identification of NERD. Positive and negative likelihood ratios were 3.84 and 0.32 respectively, whereas test accuracy was 78%. Conclusions A juice test with calculation of Delta5 helps in the identification of true NERD among heartburn patients with endoscopy-negative reflux disease. In these patients, an elevated Delta5 could make prolonged reflux testing unnecessary. (J Neurogastroenterol Motil 2018;24:233-240)application/pdfengJournal of neurogastroenterology and motility. Seoul, Korea : The Korean Society of Neurogastroenterology and Motility. Vol. 24, no. 2 (Apr. 2018), p. 233-240Monitoramento do pH esofágicoAziaRefluxo gastroesofágicoEstatística médicaDelta5Esophageal pH monitoringJuice testNonerosive reflux diseaseJuice test for identification of nonerosive reflux disease in heartburn patientsEstrangeiroinfo:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/openAccessreponame:Repositório Institucional da UFRGSinstname:Universidade Federal do Rio Grande do Sul (UFRGS)instacron:UFRGSORIGINAL001068252.pdf001068252.pdfTexto completo (inglês)application/pdf355591http://www.lume.ufrgs.br/bitstream/10183/180058/1/001068252.pdfaa0ee13f6d020baea94bd9149dd9d0a4MD51TEXT001068252.pdf.txt001068252.pdf.txtExtracted Texttext/plain33854http://www.lume.ufrgs.br/bitstream/10183/180058/2/001068252.pdf.txt82618a124d37124330947d80925a0fc9MD5210183/1800582018-07-05 02:25:34.179354oai:www.lume.ufrgs.br:10183/180058Repositório de PublicaçõesPUBhttps://lume.ufrgs.br/oai/requestopendoar:2018-07-05T05:25:34Repositório Institucional da UFRGS - Universidade Federal do Rio Grande do Sul (UFRGS)false |
dc.title.pt_BR.fl_str_mv |
Juice test for identification of nonerosive reflux disease in heartburn patients |
title |
Juice test for identification of nonerosive reflux disease in heartburn patients |
spellingShingle |
Juice test for identification of nonerosive reflux disease in heartburn patients Fernandes, Michel Ribeiro Monitoramento do pH esofágico Azia Refluxo gastroesofágico Estatística médica Delta5 Esophageal pH monitoring Juice test Nonerosive reflux disease |
title_short |
Juice test for identification of nonerosive reflux disease in heartburn patients |
title_full |
Juice test for identification of nonerosive reflux disease in heartburn patients |
title_fullStr |
Juice test for identification of nonerosive reflux disease in heartburn patients |
title_full_unstemmed |
Juice test for identification of nonerosive reflux disease in heartburn patients |
title_sort |
Juice test for identification of nonerosive reflux disease in heartburn patients |
author |
Fernandes, Michel Ribeiro |
author_facet |
Fernandes, Michel Ribeiro Oliveira, Marina de Callegari-Jacques, Sidia Maria Gonçalves, Gissele Vargas da Rosa Fornari, Fernando |
author_role |
author |
author2 |
Oliveira, Marina de Callegari-Jacques, Sidia Maria Gonçalves, Gissele Vargas da Rosa Fornari, Fernando |
author2_role |
author author author author |
dc.contributor.author.fl_str_mv |
Fernandes, Michel Ribeiro Oliveira, Marina de Callegari-Jacques, Sidia Maria Gonçalves, Gissele Vargas da Rosa Fornari, Fernando |
dc.subject.por.fl_str_mv |
Monitoramento do pH esofágico Azia Refluxo gastroesofágico Estatística médica |
topic |
Monitoramento do pH esofágico Azia Refluxo gastroesofágico Estatística médica Delta5 Esophageal pH monitoring Juice test Nonerosive reflux disease |
dc.subject.eng.fl_str_mv |
Delta5 Esophageal pH monitoring Juice test Nonerosive reflux disease |
description |
Background/Aims Evaluation of esophageal clearance by orange juice swallowing could be useful to identify different categories of gastroesophageal reflux disease. We determined whether a juice test at the beginning of esophageal pH monitoring can identify nonerosive reflux disease (NERD) among heartburn patients. Methods Multiple swallows of orange juice (pH 3) were performed at the beginning of esophageal pH monitoring in 71 heartburn patients off acid-suppressive therapy. The area between pH drop below 5 and recovery to 5 was calculated from pH tracings and named Delta5 (mmol∙L-1∙sec). Fifteen healthy subjects served to determine Delta5 cutoff (95th percentile). Patients were classified as NERD, non- NERD (a mix of reflux hypersensitivity, functional heartburn, and undetermined), and erosive disease depending on acid exposure, reflux symptom analysis, and upper endoscopy. Results Delta5 cutoff in healthy subjects was 251 mmol·L-1∙sec. Among 71 patients, 23 had NERD, 26 had non-NERD, and 22 had erosive disease. Compared to non-NERD, Delta5 was higher in both NERD (median [interquartile range]: 316 [213-472] vs 165 [105-225]; P < 0.01) and erosive disease (310 [169-625] vs 165 [105-225]; P < 0.01). An elevated Delta5 (> 251 mmol∙L-1∙sec) showed sensitivity of 74% and specificity of 81% for identification of NERD. Positive and negative likelihood ratios were 3.84 and 0.32 respectively, whereas test accuracy was 78%. Conclusions A juice test with calculation of Delta5 helps in the identification of true NERD among heartburn patients with endoscopy-negative reflux disease. In these patients, an elevated Delta5 could make prolonged reflux testing unnecessary. (J Neurogastroenterol Motil 2018;24:233-240) |
publishDate |
2018 |
dc.date.accessioned.fl_str_mv |
2018-07-04T02:26:59Z |
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2018 |
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Estrangeiro info:eu-repo/semantics/article |
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http://hdl.handle.net/10183/180058 |
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2093-0887 |
dc.identifier.nrb.pt_BR.fl_str_mv |
001068252 |
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http://hdl.handle.net/10183/180058 |
dc.language.iso.fl_str_mv |
eng |
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dc.relation.ispartof.pt_BR.fl_str_mv |
Journal of neurogastroenterology and motility. Seoul, Korea : The Korean Society of Neurogastroenterology and Motility. Vol. 24, no. 2 (Apr. 2018), p. 233-240 |
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