Full Text
The Full Text of this article is available as a PDF (142.6 KB).
Figure 1 .
Question designed to determine whether heartburn was a predominant symptom (patients were instructed to tick only one box).
Figure 2 .
Twenty four hour oesophageal acid exposure data for 123 patients from the study by Lauritsen and colleagues,15 from whom pH data were available (data on file, AstraZeneca, Mölndal, Sweden).
Figure 3 .

Twenty four hour oesophageal acid exposure data for 451 patients who had troublesome heartburn but no oesophageal mucosal breaks.11
Figure 4 .

Graphical presentation of data on the association of individual symptom episodes with acid reflux events for patients who had normal levels of oesophageal acid exposure.22 Patients were subdivided according to whether they had moderate or severe heartburn, or mild or no heartburn. A substantial minority of patients with predominant heartburn had a relatively high level of association of symptoms with reflux.
Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- An evidence-based appraisal of reflux disease management--the Genval Workshop Report. Gut. 1999 Apr;44 (Suppl 2):S1–16. doi: 10.1136/gut.44.2008.s1. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Armstrong D., Bennett J. R., Blum A. L., Dent J., De Dombal F. T., Galmiche J. P., Lundell L., Margulies M., Richter J. E., Spechler S. J. The endoscopic assessment of esophagitis: a progress report on observer agreement. Gastroenterology. 1996 Jul;111(1):85–92. doi: 10.1053/gast.1996.v111.pm8698230. [DOI] [PubMed] [Google Scholar]
- Bytzer P., Havelund T., Hansen J. M. Interobserver variation in the endoscopic diagnosis of reflux esophagitis. Scand J Gastroenterol. 1993 Feb;28(2):119–125. doi: 10.3109/00365529309096057. [DOI] [PubMed] [Google Scholar]
- Carlsson R., Dent J., Bolling-Sternevald E., Johnsson F., Junghard O., Lauritsen K., Riley S., Lundell L. The usefulness of a structured questionnaire in the assessment of symptomatic gastroesophageal reflux disease. Scand J Gastroenterol. 1998 Oct;33(10):1023–1029. doi: 10.1080/003655298750026697. [DOI] [PubMed] [Google Scholar]
- Carlsson R., Dent J., Watts R., Riley S., Sheikh R., Hatlebakk J., Haug K., de Groot G., van Oudvorst A., Dalväg A. Gastro-oesophageal reflux disease in primary care: an international study of different treatment strategies with omeprazole. International GORD Study Group. Eur J Gastroenterol Hepatol. 1998 Feb;10(2):119–124. [PubMed] [Google Scholar]
- Chiba N., De Gara C. J., Wilkinson J. M., Hunt R. H. Speed of healing and symptom relief in grade II to IV gastroesophageal reflux disease: a meta-analysis. Gastroenterology. 1997 Jun;112(6):1798–1810. doi: 10.1053/gast.1997.v112.pm9178669. [DOI] [PubMed] [Google Scholar]
- Dent J. Gastro-oesophageal reflux disease. Digestion. 1998 Aug;59(5):433–445. doi: 10.1159/000007521. [DOI] [PubMed] [Google Scholar]
- Galmiche J. P., Barthelemy P., Hamelin B. Treating the symptoms of gastro-oesophageal reflux disease: a double-blind comparison of omeprazole and cisapride. Aliment Pharmacol Ther. 1997 Aug;11(4):765–773. doi: 10.1046/j.1365-2036.1997.00185.x. [DOI] [PubMed] [Google Scholar]
- Hewson E. G., Sinclair J. W., Dalton C. B., Richter J. E. Twenty-four-hour esophageal pH monitoring: the most useful test for evaluating noncardiac chest pain. Am J Med. 1991 May;90(5):576–583. [PubMed] [Google Scholar]
- Johnsson F., Joelsson B. Reproducibility of ambulatory oesophageal pH monitoring. Gut. 1988 Jul;29(7):886–889. doi: 10.1136/gut.29.7.886. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Johnsson F., Roth Y., Damgaard Pedersen N. E., Joelsson B. Cimetidine improves GERD symptoms in patients selected by a validated GERD questionnaire. Aliment Pharmacol Ther. 1993 Feb;7(1):81–86. doi: 10.1111/j.1365-2036.1993.tb00073.x. [DOI] [PubMed] [Google Scholar]
- Klauser A. G., Schindlbeck N. E., Müller-Lissner S. A. Symptoms in gastro-oesophageal reflux disease. Lancet. 1990 Jan 27;335(8683):205–208. doi: 10.1016/0140-6736(90)90287-f. [DOI] [PubMed] [Google Scholar]
- Lambert J. R., Midolo P. The actions of bismuth in the treatment of Helicobacter pylori infection. Aliment Pharmacol Ther. 1997 Apr;11 (Suppl 1):27–33. doi: 10.1046/j.1365-2036.11.s1.13.x. [DOI] [PubMed] [Google Scholar]
- Lind T., Havelund T., Carlsson R., Anker-Hansen O., Glise H., Hernqvist H., Junghard O., Lauritsen K., Lundell L., Pedersen S. A. Heartburn without oesophagitis: efficacy of omeprazole therapy and features determining therapeutic response. Scand J Gastroenterol. 1997 Oct;32(10):974–979. doi: 10.3109/00365529709011212. [DOI] [PubMed] [Google Scholar]
- Locke G. R., 3rd, Talley N. J., Fett S. L., Zinsmeister A. R., Melton L. J., 3rd Prevalence and clinical spectrum of gastroesophageal reflux: a population-based study in Olmsted County, Minnesota. Gastroenterology. 1997 May;112(5):1448–1456. doi: 10.1016/s0016-5085(97)70025-8. [DOI] [PubMed] [Google Scholar]
- Lundell L. R., Dent J., Bennett J. R., Blum A. L., Armstrong D., Galmiche J. P., Johnson F., Hongo M., Richter J. E., Spechler S. J. Endoscopic assessment of oesophagitis: clinical and functional correlates and further validation of the Los Angeles classification. Gut. 1999 Aug;45(2):172–180. doi: 10.1136/gut.45.2.172. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Small P. K., Loudon M. A., Waldron B., Smith D., Campbell F. C. Importance of reflux symptoms in functional dyspepsia. Gut. 1995 Feb;36(2):189–192. doi: 10.1136/gut.36.2.189. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Venables T. L., Newland R. D., Patel A. C., Hole J., Wilcock C., Turbitt M. L. Omeprazole 10 milligrams once daily, omeprazole 20 milligrams once daily, or ranitidine 150 milligrams twice daily, evaluated as initial therapy for the relief of symptoms of gastro-oesophageal reflux disease in general practice. Scand J Gastroenterol. 1997 Oct;32(10):965–973. doi: 10.3109/00365529709011211. [DOI] [PubMed] [Google Scholar]


