(1) Although GORD is primarily a motor disorder, the injurious effects of gastric acid are central to the pathogenic process of oesophagitis, and the severity of disease correlates with the degree and duration of oesophageal acid exposure.
(2) The ambulatory 24 hour pH test may have rendered the AP test obsolete in the assessment of GORD as the cause of NCCP.
(3) Epidemiological studies of gastro-oesophageal reflux disease (GORD) are confounded by the lack of a standardized definition and a diagnostic 'gold-standard' for the disorder.
(4) Using 24 hour pH monitoring as a reference standard, the usefulness of the acid perfusion (AP) test in predicting gastro-oesophageal reflux disease (GORD) was assessed in 71 non-cardiac chest pain (NCCP) patients and 23 endoscopic oesophagitis patients.
(5) This may be made worse by relative gastric acid hypersecretion in some patients with severe GORD.
(6) The aim of this study was to investigate the association of gastro-oesophageal reflux disease (GORD) with radiographic pulmonary changes.
(7) The pathogenesis of GORD depends on a mix of factors which vary amongst individual patients.
(8) In the NCCP population with a normal oesophageal examination (1) AP test reproduction of chest pain is poorly predictive of GORD; (2) AP test reproduction of heartburn is more predictive of GORD but does not ensure that the chest pain is caused by GORD; (3) a negative AP test does not exclude GORD and (4) only 48% of AP test positive patients have demonstrable acid mediated chest pain.
(9) Although these data are not conclusive, it seems prudent, if possible, to avoid the use of NSAIDs in patients with GORD, particularly those with oesophageal stricture.
(10) In patients with more severe grades of oesophagitis, there are abnormally high levels of nocturnal acid exposure, with the intra-oesophageal pH being less than 4.0 for 36% of the time, compared with 5% of the time in patients with mild GORD.
(11) In Western countries, 20-40% of the adult population experience heartburn, which is the cardinal symptom of GORD, but only some 2% of adults have objective evidence of reflux oesophagitis.
(12) Of patients with oesophagitis 29% had no typical symptoms of GORD; only 24% of patients with regurgitation had oesophagitis.
(13) Although GORD causes substantial morbidity, the annual mortality rate due to GORD is very low (approximately 1 death per 100,000 patients), and even severe GORD has no apparent effect on longevity, although the quality of life can be significantly impaired.
(14) A third of the patients reported such inconclusive symptomatology at history-taking that no preliminary diagnosis about the presence or absence of GORD could be made.
(15) The limited information available about salivation in GORD patients suggests that salivary secretion is no different from that of age-matched controls, but that there is an age-dependent loss of the salivary response to oesophageal acidification.
(16) The long duration of action and effective inhibition of meal-stimulated acid secretion probably explains the superiority of omeprazole in treating GORD.
(17) In the 105 of these patients in whom there was any suspicion of GORD, 24-hour pH monitoring was carried out.
(18) When patients were divided according to their symptoms suggestive of GORD, lower VC%, FVC%, and FEV1% were found in patients with than in those without symptoms (87 vs 102, p = 0.0018; 76 vs 91, p = 0.0099; 80 vs 93, p = 0.0026).
(19) The signs and symptoms of GORD often wax and wane in intensity, and spontaneous remissions have been reported.
(20) Of several symptoms thought to be related to gastrooesophageal reflux disease (GORD), only heartburn (68% vs 48%) and acid regurgitation (60% vs 48%) occurred in more of the patients with GORD (as determined by pH monitoring) than of those with normal pH monitoring.
Heartburn
Definition:
(n.) An uneasy, burning sensation in the stomach, often attended with an inclination to vomit. It is sometimes idiopathic, but is often a symptom of often complaints.
Example Sentences:
(1) Nausea and heartburn occurred in 3 cases only and were controlled by reducing the dosage.
(2) A 62-year-old man with severe heartburn and persistent hiccups despite numerous diagnostic tests and therapeutic drug trials presented to our clinic.
(3) We speculate that hormone-related impairment of distal oesophageal clearance mechanisms may have a crucial bearing on whether heartburn develops in those individuals at greatest risk.
(4) Heartburn was induced by a meal consisting of chili, black coffee, and a spicy tomato drink mix.
(5) Heartburn was the most common symptom, more frequent in females than in males (p less than 0.01).
(6) Primary symptoms include dysphagia, odynophagia, heartburn and central chest pain.
(7) Symptoms of heartburn, regurgitation, and dysphagia were absent or minimal in most patients.
(8) The occurrence of heartburn did not correlate with the extent of reflux in the pH study.
(9) However, onions significantly increased all measures in heartburn subjects, compared with the no-onion condition, and compared with normals under the onion condition.
(10) Heartburn and epigastric pain, monitored every other week, were significantly relieved by both treatments, but to a significantly greater extent (70% vs 20% on average, p less than 0.01) and significantly faster (p less than 0.01) in the presence of triletide.
(11) 90 patients living more than 3 months complained of the following: heartburn, 18 (20%); reflux, 12 (13.3%); retrosternal pain, 3 (3.3%); stenotic sensation, 23 (25.6%); diarrhea, 10 (11.1%); abdominal pain, 14 (15.6%); and dumping syndrome, 6 (6.7%).
(12) Only ranitidine significantly reduced heartburn frequency and severity.
(13) 1) Symptom relief: Cisapride, usually at a dose of 10 mg t.i.d., was superior to placebo and metoclopramide in relief of daytime and night-time heartburn and regurgitation.
(14) Although heartburn, thought to indicate reflux of gastric contents into the oesophagus, occurs frequently in pregnant women during the last trimester, its aetiology is not clear.
(15) No patient experienced symptoms while swallowing water but one complained of heartburn and one developed symptomatic oesophageal 'spasm' during eating.
(16) Six subjects had mild subjective side effects after zindotrine (headache, dizziness, vertigo, flushing, and heartburn) compared with one report of lightheadedness after placebo.
(17) Logistic regression analysis showed increased risk of suffering heartburn with increasing gestational age (P < 0.0001), pre-pregnancy heartburn (P < 0.0001), parity (P < 0.0001) and inversely with maternal age (P < 0.05) but not with body mass index before pregnancy, race, or weight gain in pregnancy.
(18) Patients with gastroesophageal reflux often describe heartburn after "spicy meals."
(19) Heartburn, the most common presenting symptom, was abolished in 85.5% and epigastric pain in 84.6% of patients.
(20) Despite randomization of endoscopically normal patients, those treated with ranitidine had significantly more heartburn at baseline.