Diagnosis of gastroesophageal reflux disease in elderly subjects using 24-hour esophageal pH monitoring

Objective To evaluate the relationship between the parameters of 24-hour es ophageal pH monitoring and gastroesophageal reflux disease (GERD) among eld erly subjects. Methods Twenty-four-hour esophageal pH monitoring was carried out in 20 eld erly subjects without apparent GERD symptoms (controls) and 69 suspected GE RD subjects. Results Normal values of the parameters from 20 elderly controls were obtai ned. Percent of total time, percent of supine time and percent of upright t ime in which the pH was < 4 (indicating reflux) were less than 3.3%, 1.4%, 5.5%, respectively. The number of reflux episodes and episodes lasting long er than 5 minutes were less than 65 and 2 times respectively. The values ob tained in 66 GERD suspected subjects were significantly different from thos e in normal controls. The differences of reflux parameters between the esop hagitis group and non-esophagitis group, such as percent of total time with pH < 4, percent of supine time with pH < 4 and number of reflux lasting lo nger than 5 minutes were also significant. Conclusions About 51.6% patients (34/66) with reflux symptoms but without e ndoscopic evidence of esophagitis were definitely diagnosed as GERD by esop hageal pH monitoring. Duration of esophageal acid exposure correlated with the severity of GERD.