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.
BACKGROUND: 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. OBJECTIVE: To evaluate whether the symptoms in GERD patients are related to the intensity of gastroesophageal acid reflux. METHODS: 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). RESULTS: 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. CONCLUSION: There is a moderate positive correlation between heartburn and gastroesophageal reflux measurement. Dysphagia has a weak positive correlation with reflux measurement.
背景：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。
目的：评估 GERD 患者的症状是否与胃食管酸反流强度有关。
方法：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）。
结果：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。
结论：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。
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