Diagnosis of gastroesophageal reflux disease in elderly subjects using 24-hour esophageal pH monitoring.

OBJECTIVE: To evaluate the relationship between the parameters of 24-hour esophageal pH monitoring and gastroesophageal reflux disease (GERD) among elderly subjects. METHODS: Twenty-four-hour esophageal pH monitoring was carried out in 20 elderly subjects without apparent GERD symptoms (controls) and 69 suspected GERD subjects. RESULTS: Normal values of the parameters from 20 elderly controls were obtained. Percent of total time, percent of supine time and percent of upright time in which the pH was < 4 (indicating reflux) were less than 3.3%, 1.4%, 5.5%, respectively. The number of reflux episodes and episodes lasting longer than 5 minutes were less than 65 and 2 times respectively. The values obtained in 66 GERD suspected subjects were significantly different from those in normal controls. The differences of reflux parameters between the esophagitis group and non-esophagitis group, such as percent of total time with pH < 4, percent of supine time with pH < 4 and number of reflux lasting longer than 5 minutes were also significant. CONCLUSIONS: About 51.6% patients (34/66) with reflux symptoms but without endoscopic evidence of esophagitis were definitely diagnosed as GERD by esophageal pH monitoring. Duration of esophageal acid exposure correlated with the severity of GERD.