Patients with functional heartburn are more likely to report retrosternal discomfort during wireless pH monitoring

YI-CHIA LEEHSIU-PO WANGHAN-MO CHIUHuang S.-P.CHIA-HUNG TUMING-SHIANG WULin J.-T.2021-01-152021-01-1520050016-5107https://www.scopus.com/inward/record.uri?eid=2-s2.0-27844561482&doi=10.1016%2fS0016-5107%2805%2900317-2&partnerID=40&md5=a17bad88c4c88c19e06867b5fda09031https://scholars.lib.ntu.edu.tw/handle/123456789/541197Background: Although the wireless Bravo pH system is effective, some patients experience retrosternal sensations possibly caused by esophageal sensitivity that may complicate clinical application. Methods: Ambulatory pH of 40 consecutive patients with GERD who had erosive esophagitis or nonerosive reflux disease, were monitored for 2 days with the Bravo system. Results were stratified and compared on the basis of self-awareness of the intraesophageal capsule. Results: Pathologic acid reflux was diagnosed in 20 patients and normal reflux was diagnosed in 20 patients. Seventeen patients (42.5%) reported retrosternal discomfort, and 12 of them (70.6%) had normal reflux. Patients with retrosternal discomfort were less likely to have moderate endoscopic esophagitis, i.e., Los Angeles classification grades B, C, and D endoscopic esophagitis (p = 0.006), and were less likely to have significantly elevated esophageal acid exposure (p = 0.0036) than those who did not perceive the discomfort. Reported discomfort was not associated with age, gender, or the presence of endoscopic esophagitis. Conclusions: The negative correlation between Bravo-capsule-induced retrosternal discomfort and esophageal-acid exposure indicates modified mechanical afferent nerve function after long-term acid stimulation. Capsule-induced retrosternal discomfort in the presence of normal acid exposure suggests functional heartburn. Copyright ? 2005 by the American Society for Gastrointestinal Endoscopy.[SDGs]SDG3adult; aged; article; clinical article; controlled study; correlation analysis; disease classification; esophagus; esophagus pH; female; gastroesophageal reflux; heartburn; human; male; pH measurement; priority journal; reflux esophagitis; sensation; sex difference; statistical significance; Adult; Aged; Aged, 80 and over; Chest Pain; Esophageal pH Monitoring; Esophagitis; Esophagoscopy; Female; Gastroesophageal Reflux; Heartburn; Humans; Male; Middle Aged; Monitoring, AmbulatoryPatients with functional heartburn are more likely to report retrosternal discomfort during wireless pH monitoringjournal article10.1016/S0016-5107(05)00317-2163010222-s2.0-27844561482