Abnormal oesophageal pH-monitoring in patients with functional thoracic and abdominal disorders

Controversial data are reported on the diagnostic yield of oesophageal pH-monitoring in clinical routine. The aim of this study was to determine the diagnostic importance of oesophageal pH-monitoring in the work-up of functional thoraco-abdominal disorders.

The prevalence of abnormalities in pH-monitoring was evaluated in 238 patients with functional complaints: typical reflux symptoms (n = 56), non-cardiac chest pain (n = 98), non-ulcer dyspepsia (n = 52), and unclassifiable abdominal pain (n = 32). A symptom index was calculated for reflux-related symptoms in patients experiencing symptoms during the measurement (n = 74).

The rate of patients with an abnormal pH-monitoring were in patients with reflux symptoms non-cardiac chest pain, non-ulcer dyspepsia and unclassified abdominal pain 55, 50, 44 and 34%, respectively. A symptom index of at least 50% was observed in 77, 55, 50 and 60% in the four groups respectively.

The high rate of abnormal oesophageal pH-monitoring and symptom related reflux events in the investigated patients emphasizes the importance of 24-hour oesophageal pH-measurement in the diagnostic work-up of functional thoracic and abdominal disorders.