HEARTBURN CORRELATED TO 24-HOUR PH MONITORING AND RADIOGRAPHIC EXAMINATION OF THE ESOPHAGUS

Objectives: Study relationship of gastroesophageal reflux disease to f indings on radiographic examination of the esophagus, Methods: We corr elated heartburn (HE) in 360 patients (174 women; 186 men; mean age, 5 3 yr) to results of pH monitoring (pHM) and radiographic examination o f the esophagus, Radiographic findings were categorized as normal (n = 129), hiatal hernia (HH) only (n = 173), reflux esophagitis (n = 50), or peptic stricture (n = 8) (ES; 58), Abnormal pHM was defined as tot al percentage of esophageal acid exposure time (pH < 4) of 6% or great er, Results: pHM was abnormal in 41 (31%) of 132 patients with HE vers us 54 (24%) of 228 without the symptom (p > 0.05), Radiographic correl ation showed abnormal pHM in only 21 (16%) of 129 patients with a norm al esophagus, 52 (30%) of 173 with HH, and 22 (38%) of 58 with ES, whi ch was significantly lower for those with a normal esophagus, In 132 p atients with HE, those with normal esophagus had lower abnormal pHM (2 of 38; 5%) compared with patients with HH (24 of 64; 38%) or with ES (15 of 30; 50%) (p < 0.05), In the 228 patients without HE, abnormal p HM was found in 19 (21%) of 91 ,vith a normal esophagus, 28 (26%) of 1 09 with HH, and 7 (25%) of 28 with ES (p > 0.05), Conclusions: (1) pHM findings did not correlate with presence or absence of HE; (2) pHM is usually normal in patients with normal esophagus on RE; (3) pHM is al so usually normal in patients with HE and normal esophagus on RE; and (4) PHM is often normal in patients with radiographic findings of refl ux esophagitis or peptic stricture.