Etiology Analysis And Clinical Characteristics Of Patients With Heartburn

Objective: According to the Montreal’s definition of gastroesophageal reflux disease andRome Ⅲ criteria of the functional heartburn’s diagnosis, Patients with heartburn underwentendoscopy、24h esophageal pH monitoring、PPI trial and were stratified into differentgroups，Our aim was to study clinical classification and characteristics among the differentheartburn groups.Methods: Patients with typical heartburn symptoms were recruited into the research fromgastrointestinal clinics and endoscopy center of the first hospital of Jilin University. Allpatients were initially evaluated by a symptom questionnaire under the guidance of digestivephysician, and thereafter underwent an upper endoscopy，patients with damaged esophagealmucosa were classified into RE type in GERD group，those with normal-appearingesophageal mucosa were followed by ambulatory24h esophageal pH monitoring includingcounting symptom index and then administrated by PPI trial，those patients having a normalesophageal mucosa were stratified into NERD and FH based on24h esophageal pHmonitoring、symptom index and PPI trial，and the last analyse the different Characteristics ofdifferent heartburn groups.Results: Eighty patients with typical heartburn symptoms were enrolled, including43maleand37female，mean age51±12years. All the patients will be divided into three groups:twenty patients had RE,46NERD, and14FH(M/F:15/5,23/23,5/9, mean age:52±13,50±11,51±11, respectively). There was no statistically significant difference between threegroups of age and gender. Combined with esophageal pH monitoring、symptom index andPPI trial, and NERD subdivided into3subgroups：20patients were testified with excessiveacid exposure；13patients were found with normal acid exposure and positive SI at the sametime；the other13cases had positive PPI trial although they had normal pH monitoring andnegative SI．After complete classification, comparing the differences in esophageal pHmonitoring of different classification. Statistical analysis shows the degree of esophageal acid exposure of NERD group(pH+or pH﹣) was significantly higher than that of the FHgroup；There were significant differences of the degree of esophageal acid exposure among3subgroups of NERD；Statistical analysis showed that reflux esophagus LA grade didn’t havecorrelation with the symptom scores.Conclusion:1. Heartburn is a common symptom in the digestive system，this symptom can be found ina variety of diseases，Common species of diseases can be divided into RE、NERD andFH,NERD and FH is heterogeneous diseases with different characteristics.2. Combined with esophageal pH monitoring、symptom index and PPI trial, NERDsubdivided into3subgroups: excessive acid exposure、normal acid exposure and positiveSI、normal pH monitoring and negative SI but positive PPI trial，There were significantdifferences of the degree of esophageal acid exposure among3subgroups of NERD3. The degree of esophageal acid exposure of NERD group(pH+or pH﹣) of significantlywas higher than that of the FH group4. Reflux esophagus LA grade didn’t have correlation with the symptom scores.