Supplement Abstracts Submitted for the 70th Annual Scientific Meeting of the American College of Gastroenterology: ESOPHAGUS
Purpose: To investigate whether symptoms of heartburn correlate with documented acid reflux events in a subgroup of patients with classic, chronic heartburn and an “acid-sensitive” esophagus as defined by a positive Bernstein test.
Methods: Twenty-eight patients were identified by a trained physician to have symptoms of classic, chronic heartburn occurring on a daily basis. Bernstein testing was performed followed by prolonged esophageal pH monitoring, during which patients self-reported symptoms of heartburn. The relationship between symptoms of heartburn and acid reflux events was reported as a symptom index (SI).
Results: Thirteen patients (46%) had a positive Bernstein test while 15 (54%) had a negative test. Twenty-one patients reported heartburn symptoms during prolonged esophageal pH monitoring, 8 in the Bernstein-positive group and 13 in the Bernstein-negative group.
Conclusions: Even in patients who report “classic” symptoms of heartburn and in whom a Bernstein test confirms sensitivity to acid, the correlation between heartburn symptoms and objective acid reflux is poor. This finding suggests that other factors besides reflux of gastric acid may be involved in the generation of heartburn symptoms in many patients.