Rabeprazole test for the diagnosis of gastro-oesophageal reflux disease: results of a study in a primary care setting

World J Gastroenterol. 2006 Apr 28;12(16):2569-73. doi: 10.3748/wjg.v12.i16.2569.


Aim: To determine the diagnostic value of the rabeprazole test in patients seen by general practitioners.

Methods: Eighty-three patients with symptoms suggestive of GERD were enrolled by general practitioners in this multi-centre, randomized and double-blind study. All patients received either rabeprazole (20 mg bid) or a placebo for one week. The diagnosis of GERD was established on the presence of mucosal breaks at endoscopy and/or an abnormal esophageal 24-h pH test. The test was considered to be positive if patients reported at least a "clear improvement" of symptoms on a 7-point Likert scale.

Results: The sensitivities of the test for rabeprazole and the placebo were 83% and 40%, respectively. The corresponding specificity, positive and negative predictive values were 45% and 67%, 71% and 71%, and 62% and 35%, respectively. A receiver operating characteristics (ROC) analysis confirmed that the best discriminatory cut-off corresponded to description of "clear improvement".

Conclusion: The poor specificity of the proton-pump inhibitor (PPI) test does not support such an approach to establish a diagnosis of GERD in a primary care setting.

Publication types

  • Multicenter Study
  • Randomized Controlled Trial

MeSH terms

  • 2-Pyridinylmethylsulfinylbenzimidazoles
  • Adult
  • Anti-Ulcer Agents*
  • Benzimidazoles* / adverse effects
  • Double-Blind Method
  • Female
  • Gastroesophageal Reflux / diagnosis*
  • Humans
  • Hydrogen-Ion Concentration
  • Male
  • Middle Aged
  • Omeprazole / adverse effects
  • Omeprazole / analogs & derivatives*
  • Physicians, Family
  • Rabeprazole
  • Sensitivity and Specificity


  • 2-Pyridinylmethylsulfinylbenzimidazoles
  • Anti-Ulcer Agents
  • Benzimidazoles
  • Rabeprazole
  • Omeprazole