Omeprazole as a diagnostic tool in gastroesophageal reflux disease

Schenk, B.E.; Kuipers, E.J.; Klinkenberg‐Knol, E. C.; Festen, H. P. M.; Jansen, Erik; Tuynman, H. A. R. E.; Schrijver, M.; Dieleman, Levinus A.; Meuwissen, S. G. M.

doi:10.1016/s0736-4679(98)80030-9

Cited by 105 publications

(101 citation statements)

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“…Relief of symptoms with 1 wk of omeprazole 20 mg twice daily had a sensitivity of 75% and a specificity of 55% when compared with endoscopy and ambulatory pH testing (27). In another study, using pH as the gold-standard, an omeprazole trial had a positive and negative predictive value of 68% and 63%, respectively, and when the omepra- Practice Guidelines for GERD zole trial was considered the standard, the pH test had identical positive and negative predictive values (28). Neither a PPI trial nor ambulatory pH testing should be considered to provide absolute proof or disproof of GERD and in difficult cases both may be needed for the highest diagnostic certainty.…”

Section: Endoscopy In Gerdmentioning

confidence: 98%

Updated guidelines for the diagnosis and treatment of gastroesophageal reflux disease

DeVault¹

1999

The American Journal of Gastroenterology

143

178

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PREAMBLEGuidelines for the diagnosis and treatment of gastroesophageal reflux disease (GERD) were published by the American College of Gastroenterology in 1995 (1). These and other guidelines undergo periodic review. Significant advances have been made in the area of GERD over the past several years, leading us to review and revise our previous guidelines statements. These advances have included an increase in our comfort with the chronic use of proton pump inhibitors and an increased acceptance of laparoscopic antireflux surgery, among other factors. These and the original guidelines are intended to apply to all physicians who address GERD and are intended to indicate the preferable, but not only acceptable, approach. Physicians must always choose the course best suited to the individual patient and the variables that exist at the moment of the decision. These guidelines are intended to apply to adult patients with the symptoms, tissue damage, or both that result from the reflux of gastric contents into the esophagus. For the purpose of these guidelines GERD is defined as chronic symptoms or mucosal damage produced by the abnormal reflux of gastric contents into the esophagus.Both these and the original guidelines were developed under the auspices of the American College of Gastroenterology and its Practice Parameters Committee, and approved by the Board of Trustees. The world literature was reviewed extensively for the original guidelines and was once again reviewed using the National Library of Medicine database. All appropriate studies were reviewed and any additional studies found in the reference list of these papers were obtained and reviewed. Evidence was evaluated along a hierarchy, with randomized controlled trials given the greatest weight. Abstracts presented at national and international meetings were only used when unique data from ongoing trials were presented. When scientific data were lacking, recommendations were based on expert consensus. During preparation, the guidelines were reviewed

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Section: Endoscopy In Gerdmentioning

confidence: 98%

Updated guidelines for the diagnosis and treatment of gastroesophageal reflux disease

DeVault¹

1999

The American Journal of Gastroenterology

143

178

View full text Add to dashboard Cite

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“…11 For example, two studies revealed that 22 and 26% of patients with upper endoscopy documented erosive oesophagitis manifested normal 24-h pH probe test results. 12,13 Finally, in clinical practice the 24-h pH probe is not indicated for the routine evaluation of GERD but instead for the diagnosis of atypical symptomatology and for the assessment of subjects considering antireflux surgery. 14 Upper endoscopy also suffers flaws as a tool for diagnosing GERD.…”

Section: Introductionmentioning

confidence: 99%

“…For example, two studies noted frequencies of GERD in OSAS of 60 9 and 62%. 13 However, these studies asked for symptoms within the last 12 and 6 months while the validated questionnaire in this study asked for GERD symptoms within the last 4 weeks. A recent report did use a validated questionnaire and suggested that there was a significant correlation of GERD symptoms and the AHI.…”

mentioning

confidence: 99%

Symptoms of gastro‐oesophageal reflux disease and the severity of obstructive sleep apnoea syndrome are not related in sleep disorders center patients

Kim

Vorona

Winn

et al. 2005

Aliment Pharmacol Ther

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SUMMARYBackground: Studies suggest obstructive sleep apnea syndrome (OSAS) frequently manifests in patients with gastroesophageal reflux disease (GERD) and that there may be a causal relationship. Aim: To determine the relationship between OSAS and symptoms of GERD. Methods: Consecutive patients referred to the Sleep Disorders Center (SDC) 18 years and older with polysomnographically defined OSAS were evaluated prospectively for GERD using a validated symptoms questionnaire. The GERD and OSAS relationship was assessed by 1) determining frequency of GERD in patients with and without OSAS; 2) ascertaining the relationship between

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“…The poor performance of PPI test is further reinforced by the comparison with the placebo-test which adequately 'classified' nearly half of the patients (random results). However, these results are not entirely surprising as a good placebo response has also been reported in short-term trials in GERD [10,[16][17][18] . In addition, the above negative conclusions should be further balanced as far as negative predictive values are considered.…”

Section: Discussionmentioning

confidence: 67%

Rabeprazole test for the diagnosis of gastro-oesophageal reflux disease: Results of a study in a primary care setting

Varannes

Sacher‐Huvelin²,

Vavasseur³

et al. 2006

WJG

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AIM: T o d e t e r m i n e t h e d i a g n o s t i c v a l u e o f t h e rabeprazole test in patients seen by general practitioners. METHODS:Eighty-three patients with symptoms s u g g e s t i v e o f G E R D w e r e e n r o l l e d b y g e n e r a l practitioners in this multi-centre, randomized and doubleblind study. All patients received either rabeprazole (20 mg bid) or a placebo for one week. The diagnosis of GERD was established on the presence of mucosal breaks at endoscopy and/or an abnormal esophageal 24-h pH test. The test was considered to be positive if patients reported at least a "clear improvement" of symptoms on a 7-point Likert scale. RESULTS:The sensitivities of the test for rabeprazole and the placebo were 83% and 40%, respectively. The corresponding specificity, positive and negative predictive values were 45% and 67%, 71% and 71%, and 62% and 35%, respectively. A receiver operating characteristics (ROC) analysis confirmed that the best discriminatory cut-off corresponded to description of "clear improvement". CONCLUSION:The poor specificity of the proton-pump inhibitor (PPI) test does not support such an approach to establish a diagnosis of GERD in a primary care setting.

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Omeprazole as a diagnostic tool in gastroesophageal reflux disease

Cited by 105 publications

References 0 publications

Updated guidelines for the diagnosis and treatment of gastroesophageal reflux disease

Updated guidelines for the diagnosis and treatment of gastroesophageal reflux disease

Symptoms of gastro‐oesophageal reflux disease and the severity of obstructive sleep apnoea syndrome are not related in sleep disorders center patients

Rabeprazole test for the diagnosis of gastro-oesophageal reflux disease: Results of a study in a primary care setting

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