Correlation between oesophageal acid exposure and dyspeptic symptoms in patients with nonerosive reflux disease

Eur J Gastroenterol Hepatol. 2008 Apr;20(4):264-8. doi: 10.1097/MEG.0b013e3282f340b2.


Background & aims: Oesophageal acidification induces dyspeptic symptoms in healthy individuals. This study aimed to evaluate the correlation between oesophageal acid exposure and dyspeptic symptoms in patients with nonerosive reflux disease.

Methods: A total of 68 patients with dominant symptoms of heartburn, negative upper gastrointestinal endoscopy and concomitant dyspeptic symptoms participated in the study. The severity of dyspepsia and reflux-related symptoms was evaluated, and 24-h gastro-oesophageal pH-monitoring study was performed in all patients at baseline and after 4 weeks of therapy with esomeprazole 40 mg.

Results: Oesophageal basal acid exposure was pathological in 43 patients and normal in 25 patients, with a similar prevalence and severity of individual dyspeptic symptoms in the two groups. A significant correlation between reflux and dyspepsia scores was observed in the subgroup of patients with normal, but not in those with abnormal pHmetry (r=0.4, P=0.04 and r=0.2 P=0.07, respectively). After esomeprazole, a reduction in severity of dyspepsia (>or=50% with respect to baseline) was observed, independent of improvement of reflux-associated symptoms. Improvement in dyspepsia was, however, similar in patients with normal and abnormal basal acid exposure (14/25 vs. 33/43, respectively, P=NS).

Conclusion: Dyspeptic symptoms coexist in a subset of nonerosive reflux disease patients, but prevalence and severity of the symptoms seems to be independent of oesophageal acid exposure.

MeSH terms

  • Anti-Ulcer Agents / therapeutic use
  • Dyspepsia / drug therapy
  • Dyspepsia / etiology*
  • Esomeprazole / therapeutic use
  • Esophageal pH Monitoring / instrumentation
  • Female
  • Gastric Acid / metabolism*
  • Gastric Acid / physiology
  • Gastroesophageal Reflux / complications*
  • Gastroesophageal Reflux / drug therapy
  • Humans
  • Male
  • Middle Aged
  • Proton Pump Inhibitors / therapeutic use*
  • Treatment Outcome


  • Anti-Ulcer Agents
  • Proton Pump Inhibitors
  • Esomeprazole