Abstract :
Background:
There is no gold standard test for diagnosis of gastroesophageal reflux disease (GERD),
Methods:
regurgitation were recruited from May 2007 to January 2008. All patients completed Carlsson-Dent guestionnaire
and underwent endoscopic examination of upper gastrointestinal tract. Those with negative endoscopic examination
and questionnaire score equal to or more than four have 24 hr pH monitoring performed.
One hundred patients with dyspepsia by Rome II critieria and patients with heartburn and/or
Result:
esophagitis, 6 (6%) LA class A esophagitis, 1 (1%) gastric ulcer, and 1 (1%) duodenal ulcer. There were 21 with
insignificant endoscopic findings and 68 patients (68%) with normal finding. There were 41 with negative endoscopy
and score equal to or more than four underwent 24 hr pH monitoring. When endoscopic esophageal mucosal
breaks and 24 hr pH monitoring was used as criteria for diagnosis of GERD, the Carlsson-Dent questionnaire
positive was confirmed in 11 of 44 (25%). The sensitivity of the questionnaire for GERD diagnosis in the group
with abnormal endoscopic findings was 33% (3/9).
There were 11 patients with significant abnormal endoscopic examination, 3 (3%) LA class B
Conclusion:
GERD if the score of 4 or greater was used as positive test compared to endoscopic esophagitis or abnormal acid
reflux as assessed by 24 hr pH monitoring.
Carlsson-Dent questionnaire had a low sensitivity in picking up GERD. It over diagnosed
imprecise definitions and overlapping of symptoms between GERD and dyspepsia leading to the skepticism of the
true value of symptom based diagnosis. In previous study by R. Carlsson using structural questionnaire for the
diagnosis of GERD showed the sensitivity of 92% but a specificity of 19%. There is no data regarding the value of
structural guestionnaire in the diagnosis of GERD in Thai patients. The aim of this study is to determine usefulness
of Carlsson-Dent questionnaire in diagnosis of GERD in Thai patients compared with endoscopy or 24 hr pH
monitoring as gold standard. |
file/Thai-Journal-of-gastroenterology-vol-9-no-3-456327.pdf