[Oesophageal acid exposure test in non-erosive gastroesophageal reflux disease and the diagnostic value of rabeprazole]

To study the acid exposure characteristic of the subtypes of non-erosive gastroesophageal reflux disease (NERD) and discuss the value of rabeprazole in its diagnosis.32 cases of the NERD were subdivided into three groups--14 cases with abnormal acid reflux, 11 with acid hypersensitive oesophagus and the remaining 7 with functional heartburn. All the cases were treated with rabeprazole 10 mg bid for 2 weeks.(1) Acid exposure in each group: In the abnormal acid reflux group, the total degree of acid reflux, the degree of long reflux, the time of pH4 and the time percentage of pH4 were obviously increased as compared with the groups of acid hypersensitive oesophagus and functional heartburn; the symptom index of the group with acid hypersensitive oesophagus was apparently higher than that of the group of functional heartburn [(81.0 +/- 22.5)% vs (8.6 +/- 14.8)%, P0.01]. (2) Comparison of symptoms: There was no obvious difference in the score of typical symptoms and total score of symptoms before therapy among the groups; the score extraesophageal symptoms in the acid hypersensitive oesophagus group was much higher than that in the abnormal acid reflux group (4.0 +/- 3.8 vs 0.9 +/- 2.2, P0.05). (3) The curative effect: The score of oesophageal symptoms and the total score of symptoms in the abnormal acid reflux and the acid hypersensitive oesophagus groups after treatment with rabeprazole for 1 and 2 weeks showed obvious decrease, while in the functional heartburn group the scores showed only a declining trend, but with no statistical significance, and there was obvious distinction of the total score of symptoms in the abnormal acid reflux group as compared with the other two groups after 2 weeks of therapy. (4) The total effective rate was 56.3% and 68.8% after 1 week and 2 weeks of therapy. Rabeprazole test showed that the sensitivity and specificity for abnormal acid reflux and acid hypersensitive oesophagus were 64.0% and 71.4% after 1 week and 80.0% and 71.4% after 2 weeks of therapy.(1) The main manifestations shown by the acid exposure of abnormal acid reflux are the increase of total degree of acid reflux, the degree of long reflux and the time of pH4. (2) The patients with hypersensitive oesophagus may be much more likely to suffer from extraesophageal symptoms. (3) Rabeprazole diagnosis test is valuable in the diagnosis and subdivision of non-erosive gastroesophageal reflux disease.