S1904 The Addition of Cracker Swallow to Standard Liquid Swallow for Determining Gastroesophageal Reflux Disease Severity in Ineffective Motility Disorder

Abstract

patients registered in the PARSI database* were assessed for presence of abdominal pain. All these patients have detailed symptom recording as well as undergoing upper GI endoscopy. Endoscopic and clinical features of patients with epigastric pain were compared with those not complaining of this symptom. Results: A total of 1,124 patients (mean age 39.3 years, 56.1% female) were included. Of these 750 (66.7%) complained of epigastric pain, 52.4% of whom experienced it almost daily. Epigastric pain was the dominant symptom in 235 (40.4%) out of 581 participants whose dominant symptom was recorded. Frequency of epigastric pain was higher among women (71.8% vs. 60.2%, p-value<0.001). Furthermore, participants presenting with epigastric pain were significantly younger (37.6±14.2 vs. 42.7±15.3, p<0.001). Erosive reflux disease (ERD) was present in 656 (58.4%) and patients with epigastric pain had significantly lower prevalence of ERD than those without (55.1% vs. 65%, p=0.002). Interestingly, patients with epigastric pain were more likely to have normal stomach on endoscopy (46.6% vs. 36.7%, p=0.002). Finding a normal duodenum was equally likely between the two groups (75.8% vs. 71.8%p=0.162). Conclusion: Epigastric pain in patients with gastro-esophageal reflux disease is not associated with other upper GI pathologies. Instead it seems to be a symptom of GERD itself. Therefore, according to our data, we suggest patients with epigastric pain as their dominant complaint to be assessed for GERD even in the absence of prominent heartburn and acid regurgitation. *NasseriMoghaddam S, Razjouyan H, Alimohamadi SM, et al. Prospective Acid Reflux Study of Iran (PARSI): methodology and study design. BMC Gastroenterol 2007; 20:7:42.