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GERD evaluation: time for a new paradigm?

Irvin M Modlin1, Peter Malfertheiner, Richard H Hunt

  • 1Yale University School of Medicine, New Haven, CT 06520, USA. imodlin@optonline.net

Journal of Clinical Gastroenterology
|April 12, 2007
PubMed
Summary
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Gastroesophageal reflux disease (GERD) involves more than heartburn. The ReQuest questionnaire offers a reliable way to measure symptom changes and aid GERD diagnosis and treatment evaluation.

Area of Science:

  • Gastroenterology
  • Clinical Medicine
  • Patient-Reported Outcomes

Background:

  • Historically, heartburn and acid regurgitation were primary indicators of gastroesophageal reflux. Current understanding recognizes a broader spectrum of symptoms, including extraesophageal manifestations, as integral to gastroesophageal reflux disease (GERD).
  • Endoscopic evidence of mucosal damage has limited value in assessing therapeutic success for GERD, as most patients lack overt erosions or ulcerations and experience diverse symptoms impacting quality of life.

Purpose of the Study:

  • To evaluate multidimensional questionnaires for assessing the diverse symptomatology of GERD.
  • To identify a reliable metric for tracking subjective responses to pharmacologic therapy in GERD clinical trials, particularly for nonerosive reflux disease.

Main Methods:

  • Investigated multidimensional questionnaires to capture the full range of GERD symptoms.

Related Experiment Videos

  • Focused on the ReQuest questionnaire for its validation in diverse patient groups and cultures.
  • Proposed combining accurate symptom assessment with selective endoscopy for GERD diagnosis and treatment evaluation.

    • Main Results:

    • The ReQuest questionnaire shows promise as a validated instrument for assessing GERD symptoms.
    • It is effective in measuring changes in subjective responses to therapy for both nonerosive and erosive GERD.
    • The questionnaire may be valuable for initial GERD patient evaluation.

    Conclusions:

    • Accurate symptom delineation is crucial for understanding GERD.
    • The ReQuest questionnaire provides a reproducible metric for GERD symptom assessment.
    • A combined approach of symptom assessment and selective endoscopy is proposed for GERD diagnosis and therapy evaluation.