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Is there a correlation between scoring of gastroesophageal reflux disease and the prevalence of symptoms?
R.M. Bremner, S.F. Hoeft, T.R. DeMeester (Los Angeles),
M. Costantini (Padova)
An attempt at scoring the severity of gastroesophageal reflux disease (GERD) in terms of anatomical, functional and endoscopic abnormalities was first made by Feussner et al. in 1991 [1]. This scoring system was developed to enable comparison of results of antireflux surgery performed at different centers. To investigate whether the severity of symptoms correlates with the severity of the disease, this classification system was applied to patients with GERD presenting to a surgical esophageal clinic at the University of Southern California.
Methods
One hundred and sixty patients with GERD confirmed by pH monitoring were studied. Patients completed a detailed questionnaire regarding symptoms which were scored according to Table I. They underwent endoscopy, videoesophagography, esophageal motility and 24-hour pH monitoring. The score was based on three components of the disease, namely endoscopic anatomy, functional abnormalities (esophageal acid exposure), and pathologic mucosal injury. The final AFP score was a sum of the three components as seen in Table II. Patients were categorized into three groups according to the total AFP score representing mild (score 0-2), moderate (3-5), and severe disease (score 7-9). The prevalence of the symptoms in patients with GERD was related to these categories. Further comparison was made with the severity of symptoms and the AFP categories. The Fisher exact test was used to compare prevalence data and the Kruskall-Wallis test was used to compare scores for the different groups.
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