The value of ambulatory 24 hr esophageal pH monitoring in clinical practice in patients who were referred with persistent gastroesophageal reflux disease (GERD)-related symptoms while on standard dose anti-reflux medications

Dig Dis Sci. 2005 Oct;50(10):1909-15. doi: 10.1007/s10620-005-2960-7.


To determine the value of pH testing in clinical practice in gastroesophageal reflux disease patients who failed anti-reflux treatment. Patients resistant to standard dose proton pump inhibitor or an H2-blocker underwent pH testing. Randomly selected patients from the proton pump inhibitor failure group underwent the modified acid perfusion test as compared to patients with non-erosive reflux disease. In the proton pump inhibitor failure group (n = 70), 63.8% had a normal pH test as compared to 29% in the H2-blocker group (n = 31) (P = 0.007). Sensory intensity rating and acid perfusion sensitivity score were significantly higher in the non-erosive reflux disease control group than the proton pump inhibitor failure group (P < 0.05). Most patients who continued to be symptomatic on proton pump inhibitor once daily demonstrated a normal pH test and overall lack of increased chemoreceptor sensitivity to acid.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Esophagus / physiopathology*
  • Female
  • Gastroesophageal Reflux / complications
  • Gastroesophageal Reflux / drug therapy*
  • Gastroesophageal Reflux / physiopathology*
  • Heartburn / drug therapy
  • Heartburn / etiology
  • Heartburn / physiopathology
  • Histamine H2 Antagonists / therapeutic use*
  • Humans
  • Hydrogen-Ion Concentration
  • Male
  • Middle Aged
  • Monitoring, Ambulatory*
  • Proton Pumps / therapeutic use*
  • Referral and Consultation
  • Reproducibility of Results
  • Treatment Failure


  • Histamine H2 Antagonists
  • Proton Pumps