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Endoscopy-negative gastroesophageal reflux disease. The hypersensitive esophagus
1Division of Gastroenterology, Mayo Medical School, Mayo Clinic Jacksonville, Florida, USA.
Gastroenterology Clinics of North America
|March 1, 2000
Summary
Gastroesophageal reflux disease (GERD) often presents with normal endoscopy. Ambulatory pH testing helps classify these patients, identifying those with functional heartburn due to esophageal hypersensitivity.
Area of Science:
- Gastroenterology
- Digestive Health
- Esophageal Disorders
Background:
- Gastroesophageal reflux disease (GERD) is a common gastrointestinal disorder.
- GERD patients can have normal endoscopic findings (EGD negative).
- A significant portion of GERD patients exhibit normal endoscopy results.
Purpose of the Study:
- To review the prevalence, clinical features, symptom origin, natural history, and treatment of EGD negative GERD.
- To discuss the role of 24-hour ambulatory pH testing in evaluating EGD negative GERD patients.
- To differentiate between abnormal acid exposure and functional heartburn in EGD negative GERD.
Main Methods:
- Review of existing literature on EGD negative GERD.
- Analysis of 24-hour ambulatory pH monitoring data.
- Classification of patients based on acid exposure and symptom index.
Main Results:
- A large proportion of GERD patients have normal endoscopy.
- Ambulatory pH testing categorizes EGD negative GERD patients.
- Patients with normal acid exposure but symptom correlation may have functional heartburn.
Conclusions:
- EGD negative GERD is a distinct clinical entity.
- 24-hour pH monitoring is crucial for diagnosing functional heartburn.
- Understanding these classifications guides GERD management and treatment.