24-hour pH monitoring in symptomatic patients without erosive esophagitis who did not respond to antireflux treatment

J Clin Gastroenterol. 1994 Sep;19(2):97-9. doi: 10.1097/00004836-199409000-00003.


Twenty symptomatic patients without erosive esophagitis underwent 24-h esophageal pH monitoring after failing standard medical antireflux treatment. Sixty-five percent had abnormal esophageal acid exposure, and the majority of these improved on proton pump inhibitor therapy. However, 35% had a normal 24-h pH test. One patient had coronary artery disease, one had diffuse esophageal spasm, and two had a negative work-up and no improvement with omeprazole. Consequently, we suggest that patients like these have an omeprazole trial. If symptoms persist, 24-h esophageal pH monitoring can appropriately define more rational management. Patients with abnormal esophageal acid exposure will require more aggressive acid-control therapy, whereas those with normal esophageal acid exposure will need further work-up to assess the cause of their symptoms.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Anti-Ulcer Agents / therapeutic use
  • Esophagitis
  • Esophagus / metabolism
  • Female
  • Gastroesophageal Reflux / drug therapy
  • Gastroesophageal Reflux / physiopathology*
  • Humans
  • Hydrogen-Ion Concentration
  • Male
  • Middle Aged
  • Monitoring, Ambulatory*
  • Omeprazole / therapeutic use
  • Prospective Studies
  • Proton Pump Inhibitors
  • Treatment Failure


  • Anti-Ulcer Agents
  • Proton Pump Inhibitors
  • Omeprazole