[Relationship between gastroesophageal reflux symptoms and 24 h esophageal pH measurement in patients with normal or minimally abnormal upper endoscopies]

Heartburn and regurgitation are considered highly specific symptoms of gastroesophageal reflux. A considerable number of patients with these symptoms do not have endoscopic signs of esophagitis.To study the relationship between gastroesophageal reflux symptoms and 24 h esophageal pH mesurement in patients with normal or near normal endoscopic findings.One hundred eighty six patients with persistent reflux symptoms and absence of severe endoscopic esophagitis were studied. Pathological studies of esophageal biopsies, manometry and 24 h esophageal pH measurements were performed in all.Abnormal acid reflux was found in 131 patients (70%). No differences in the frequency of symptoms, gender or pathologic findings were observed between patients with or without abnormal acid reflux. However, a higher frequency of esophageal erosions and a lower resting pressure of the inferior sphincter of the esophagus was observed in patients with abnormal acid reflux.Thirty percent of patients with heartburn and regurgtitation did not have abnormal acid reflux. Therefore, these symptoms are not specific for gastroesophageal reflux.