위식도역류질환에서 1주 Esomeprazole 치료의 진단적 의의

Abstract

BACKGROUND/AIMS: Gastroesophageal reflux disease (GERD) can be diagnosed by symptoms, endoscopic findings, and pH monitoring. Endoscopic findings and pH monitoring have high specificity and low sensitivity. Since medical fees for the symptom-based treatment are not fully covered by insurance in Korea, endoscopy and pH monitoring are mainly being performed to prove GERD. We aimed to investigate the sensitivity of one-week PPI test in diagnosing GERD in patients with typical reflux symptoms. PATIENTS/METHODS: Patients complaining of typical symptom over twice/week were enrolled and esomeprazole (40 mg) was prescribed for one week. Frequency and severity of symptoms were analyzed and sensitivity of PPI test was calculated. GERD group was defined as having erosive esophagitis or a positive pH test. Positive rates of PPI test were calculated in GERD and non-GERD groups. RESULTS: A total of 103 patients from 11 hospitals were enrolled, and 100 of them completed until the end of the study. Seventy-nine patients reached symptomatic improvement after one-week (positive PPI test), and positive rates were 84.3% (70/83) in GERD group and 52.9% (9/17) in non-GERD, respectively (p<0.05). CONCLUSIONS: The sensitivity of PPI test in diagnosing GERD in symptomatic patients was 84.3%, and this test is considered to have diagnostic value for GERD.