Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Departamento de Oftalmologia, Otorrinolaringologia e Cirurgia de Cabeça e Pescoço, e Departamento de Clínica Médica, Ribeirão Preto, SP, Brasil.
Arq Gastroenterol. 2022 Apr-Jun;59(2):184-187. doi: 10.1590/S0004-2803.202202000-34.
Esophageal symptoms of gastroesophageal reflux are the same in functional heartburn, non-erosive disease, and erosive disease. Their patient-perceived intensity may be related to gastroesophageal reflux intensity.
To evaluate whether the symptoms in GERD patients are related to the intensity of gastroesophageal acid reflux.
To test this hypothesis, 68 patients with heartburn (18 with functional heartburn, 28 with non-erosive reflux disease, and 22 with erosive reflux disease) had their symptoms evaluated by the Velanovich score (which mainly focuses on heartburn) and the Eating Assessment Tool (EAT-10) (which focuses on dysphagia). They were submitted to esophageal endoscopy and then, on another day, they answered the Velanovich and EAT-10 questionnaires and underwent manometry and 24-hour pHmetry (measured 5 cm proximal to the upper border of the lower esophageal sphincter).
The Velanovich score was higher in patients with non-erosive and erosive diseases than in those with functional heartburn. The mean EAT-10 score did not differ between functional heartburn, erosive, and non-erosive gastroesophageal reflux disease. Considering the threshold of ≥5 to define dysphagia, 4 (22%) patients with functional heartburn, 12 (43%) with non-erosive disease, and 9 (41%) with erosive disease had dysphagia (P=0.18). There was: a) a moderate correlation between the Velanovich and DeMeester score and between Velanovich score and the percentage of acid exposure time (AET); b) a weak correlation between EAT-10 and DeMeester score and between EAT-10 and acid exposure time.
There is a moderate positive correlation between heartburn and gastroesophageal reflux measurement. Dysphagia has a weak positive correlation with reflux measurement.
胃食管反流的食管症状在功能性烧心、非糜烂性疾病和糜烂性疾病中是相同的。它们的患者感知强度可能与胃食管反流强度有关。
评估 GERD 患者的症状是否与胃食管酸反流强度有关。
为了验证这一假设，对 68 例烧心患者（功能性烧心 18 例，非糜烂性反流病 28 例，糜烂性反流病 22 例）进行了症状评估，采用 Velanovich 评分（主要关注烧心）和 Eating Assessment Tool（EAT-10）（主要关注吞咽困难）。他们接受了食管内镜检查，然后在另一天回答了 Velanovich 和 EAT-10 问卷，并进行了测压和 24 小时 pH 监测（测量距离食管下括约肌上缘 5cm 近端）。
非糜烂性和糜烂性疾病患者的 Velanovich 评分高于功能性烧心患者。功能性烧心、糜烂性和非糜烂性胃食管反流病患者的 EAT-10 评分无差异。考虑到≥5 定义为吞咽困难的阈值，4 例（22%）功能性烧心患者、12 例（43%）非糜烂性疾病患者和 9 例（41%）糜烂性疾病患者存在吞咽困难（P=0.18）。有：a）Velanovich 和 DeMeester 评分之间以及 Velanovich 评分和酸暴露时间百分比（AET）之间存在中度相关性；b）EAT-10 和 DeMeester 评分之间以及 EAT-10 和酸暴露时间之间存在弱相关性。
烧心与胃食管反流测量之间存在中度正相关。吞咽困难与反流测量呈弱正相关。
