Gastro-oesophageal reflux disease: correlation of subjective symptoms with 7 objective oesophageal function tests

Abstract

Seven tests which have been recommended for the diagnosis of gastro-esophageal reflux were applied in 24 healthy controls and in 48 patients with symptoms of reflux disease. The correlation coefficient of test results with the subjective symptoms of the patient decreased in the following order: 1) acid clearance from the distal esophagus (r = 0.558, p less than 0.001), 2) suction biopsy 5 cm above lower esophageal sphincter (LES) with evaluation of granulocytic infiltrates (r = 0.450, p less 0.001), 3) radiological demonstration of hiatal hernia (r = 0.435, p less than 0.001), 4) reflux provocation test (r = 359, p less than 0.01), 5) modified Bernstein test (r = 0.322, p less than 0.01), 6) acid relux test (r = 0.252, p less than 0.05), 7) resting pressure of LES (r = 0.246, p less than 0.05). Results of the Maudsley Personality Inventory were not correlated with subjective symptoms (r = 0.188, p greater than 0.1). By stepwise multiple regression analysis it was shown that optimal diagnosis of reflux is achieved by combination the following 4 procedures: 1) acid clearance, 2) modified Bernstein test, 3) suction biopsy, and 4) radiology.