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Abstract
Background. The aim of this study was to evaluate the reliability of symptoms in the diagnosis
of gastroesophageal reflux disease and esophageal motility disorders as assessed by
functional tests.
Methods. In 365 patients referred for suspected esophageal functional disease, symptomatic
assessment was compared with the results of esophageal manometry and ambulatory 24-hour
pH monitoring of the distal esophagus.
Results. Based on the patients' chief complaint, the symptomatic diagnosis was gastroesophageal
reflux (44%), esophageal motor disorder (26%), chest pain of esophageal origin (9%),
reflux and aspiration (8%), and abdominal pathology (12%). The symptomatic diagnosis
was considerably altered by the results of the esophageal function tests: gastroesophageal
reflux and motility disorders were found in all symptomatic diagnostic groups and
a large number of patients in each group tested normal. The sensitivity and specificity
of symptom-based diagnoses for functional disease were low.
Conclusions. The results of this study showed that symptoms are an unreliable guide of esophageal
abnormality, illustrating the need for objective testing in these patients, particularly
to avoid inappropriate medical or surgical therapy.
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Article info
Footnotes
☆Presented at the Fiftieth Annual Meeting of the Central Surgical Association, Cincinnati, Ohio, March 4–6, 1993.
Identification
Copyright
© 1993 Published by Elsevier Inc.
