Diagnostic Approach to Gastroesophageal Reflux Disease: The Role of GERD Questionnaire and PPI Test

Ummu Habibah,Achmad Fauzi

doi:10.24871/1622015112-119

Abstract

Gastroesophageal Reflux Disease (GERD), according to American College of Gastroenterology (ACG), is symptoms or mucosal damage produced by abnormal reflux of gastric contents into the esophagus. In most patients with GERD, showed no abnormalities in the endoscopic picture. This is what underlies the importance of a diagnostic tool in the form of assessment for the degree of severity of the disease based on symptoms, response to therapy and effect on the patients’ quality of life. This diagnostic tool is then formulated in the form of a questionnaire (GERD Questionnaire). Response to treatment with proton pump inhibitor (PPI) drugs is also often used to support the diagnosis of this disease.DIAMOND study is a large study which aim to assess the accuration of the questionnaire and use of PPI test. Diagnostic method with questionnaire modality and followed by PPI test have sensitivity and specificity value, which are relatively similar to the symptoms-based diagnoses performed by general practitioners or gastroenterologist, as well as when compared to endoscopy and esophageal pH monitoring. Although the diagnosis by methods of questionnaires and PPI test is not the most ideal test in term of accuracy, but these tests are not expensive, readily available and worked mainly on primary health care. These test methods are favored compared to other tests.

Highlights

Gastroesophageal reflux disease (GERD) is a gastrointestinal disease which fairly common but the prevalence very diverse worldwide.[1]
In Singapore, the prevalence of JDVWURHVRSKDJHDOUHÀX[GLVHDVH¶VV\PSWRPVLQFUHDVHG sharply from 1,6% of population in 1994 to 10,6% in 2001.1 In Indonesia, there has been no representative data to describe the incidence of this disease, but data from Rumah Sakit Cipto Mangunkusumo (RSCM) showed that there is increased of prevalence from 6% in 1997 to 26% in 2002 on patients which undergone upper gastrointestinal endoscopy
The purpose of this literature review is to know the position of GERDQ and pump inhibitor (PPI) test use in the diagnosis RI JDVWURHVRSKDJHDO UHÀX[ GLVHDVH7KLV EULHI SDSHU aims to provide a basis for the primary health care providers to not hesitate in diagnosing the JDVWURHVRSKDJHDOUHÀX[GLVHDVH

Summary

INTRODUCTION

Gastroesophageal reflux disease (GERD) is a gastrointestinal disease which fairly common but the prevalence very diverse worldwide.[1]. The purpose of this literature review is to know the position of GERDQ and PPI test use in the diagnosis RI JDVWURHVRSKDJHDO UHÀX[ GLVHDVH7KLV EULHI SDSHU aims to provide a basis for the primary health care providers to not hesitate in diagnosing the JDVWURHVRSKDJHDOUHÀX[GLVHDVH disease defined as a condition that arises due to UHÀX[ RI VWRPDFK FRQWHQWV ZKLFK FDXVHG LUULWDWLQJ symptoms and/or its complications.[1] What referred to irritating symptoms are any symptoms that lower the quality of life of patients These symptoms need to be FRQ¿UPHG LQ RUGHU WR GLIIHUHQWLDWH WKH V\PSWRPV RI JDVWURHVRSKDJHDOUHÀX[GLVHDVHIURPHSLVRGLFEXUQLQJ sentation in the chest. Dent et al reported a study entitled “Accuracy of the diagnosis of GERD by questionnaire, physicians and a trial of PPI treatment: The Diamond Study”, the result LV JDVWURHVRSKDJHDO UHÀX[ GLVHDVH GLDJQRVLV EDVHG on symptoms with questionnaire have the same accuracy as diagnosis based on symptoms by a general practitioner or gastroenterologist.[6] This test is one of the modalities to be considered when endoscopic diagnostic resources not available. How often did you have 0 stomach contents (liquid or food) moving upwards to your throat or mouth (regurgitation)?

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Findings

CONCLUSION