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.

Influência do adaptador de colchão antirrefluxo na quantidade de refluxo gastroesofágico em pacientes adultos com sintomas da doença do refluxo gastroesofágico RIBEIRÃO PRETO 2019 ANDREA DE OLIVEIRA BATISTA Influência do adaptador de colchão antirrefluxo na quantidade de refluxo gastroesofágico em pacientes adultos com sintomas da doença do refluxo gastroesofágico Dissertação apresentada à Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo para obtenção do Título de Mestre em Ciências. Área de Concentração: Morfofisiologia de Estruturas Faciais. Orientador: Prof. Dr. Roberto Oliveira Dantas RIBEIRÃO PRETO 2019 AUTORIZO A REPRODUÇÃO E DIVULGAÇÃO TOTAL OU PARCIAL DESTE TRABALHO, POR QUALQUER MEIO CONVENCIONAL OU ELETRÔNICO, PARA FINS DE ESTUDO E PESQUISA, DESDE QUE CITADA A FONTE. Palavras-chave: Doença de refluxo gastroesofágico. Pirose. Regurgitação. pHmetria. Abstract Abstract Batista AO. Influence of the anti-reflux mattress on the amount of gastroesophageal reflux in adult patients with symptoms of gastroesophageal reflux disease. Master's Thesis -Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo. Ribeirão Preto. 2019.

Background The best method to measure the frequency and duration of gastroesophageal reflux is 24-h pH or 24-h pH/impedance monitoring. However, the detection of reflux can vary when measured on different days. Our aim was to evaluate the possibility that the severity of gastroesophageal reflux is different even under similar conditions on two consecutive days. Methods We performed a 48-h pH monitoring in 12 subjects, aged 25 - 63 years, who complaint of heartburn and regurgitation, ten with esophagitis and two with non-erosive disease. The pH measurement was conducted at 5 cm from the lower esophageal sphincter. The patients stayed at the Clinical Investigation Ward of the hospital for 48 h. On each day, they consumed a 2,000 calorie diet. The results obtained on the first day were compared with those on the second day. Results Mean reflux index in the upright position was different between the two days. Results of the pH-monitoring within the 2 h after the meal revealed differences in the number of acidic reflux and reflux index episodes. Three patients had abnormal DeMeester score on one day and normal score on the other day. Considering the upper limit of 6.0% of the test duration with esophageal pH < 4 as indicative of gastroesophageal reflux disease, two patients showed abnormal results on one day and normal results on the other day. Conclusions The 24-h pH monitoring, performed on two consecutive days under similar conditions, can lead to different diagnosis of gastroesophageal reflux disease in symptomatic patients.