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Visceral sensitivity in gastroesophageal reflux
Demetrios S Theodoropoulos1, Donna L Pecoraro, Richard F Lockey
1Department of Allergy, Pediatrics and Medical Genetics, Marshfield Clinic and St. Joseph's Hospital, Marshfield, Wisconsin 54449-5777, USA.
Digestive Diseases and Sciences
|November 28, 2002
Summary
Gastroesophageal reflux disease (GERD) symptoms vary due to visceral sensitivity. Frequent reflux episodes, not acid exposure duration, correlate with higher GERD symptom scores, suggesting pH fluctuations drive symptom aggregation.
Area of Science:
- Gastroenterology
- Digestive Health
- Esophageal Physiology
Background:
- Symptomatic gastroesophageal reflux disease (GERD) presents with diverse symptoms.
- Symptom variability may stem from altered visceral sensitivity.
- Understanding GERD symptom triggers is crucial for effective management.
Purpose of the Study:
- To investigate the relationship between GERD symptom scores and objective esophageal pH findings.
- To assess the hypothesis that visceral hypersensitivity contributes to GERD symptom severity.
- To determine factors influencing the aggregation of GERD symptoms.
Main Methods:
- One hundred five patients with heartburn/retrosternal pain underwent esophageal pH monitoring.
- GERD symptoms were systematically scored for presence and frequency.
- Symptom scores were weighted for typical reflux symptoms like heartburn, retrosternal pain, and regurgitation.
Main Results:
- Patients with abnormal esophageal pH studies reported significantly more frequent GERD symptoms.
- GERD symptom scores positively correlated with the number of reflux episodes.
- Symptom scores did not correlate with the duration of esophageal acid exposure.
Conclusions:
- Frequent alternation between low and normal distal esophageal pH values is associated with symptom aggregation in GERD.
- The number of reflux events, rather than total acid contact time, appears linked to symptom intensity.
- Findings support the role of reflux frequency and associated pH fluctuations in GERD symptom perception.