UEG's educational platform for gastroenterology education bringing recordings, courses, guidelines, and more together in one place.

UEG Week Berlin 2025 Recordings Gut Guide online

Rate for better recommendations!

Your feedback helps us show you more of what you like and less of what you dislike!

More of this!

We will show you more similar content.

Not for me!

We won't suggest this again.

Bookmark!

Save this content for later!

New to myUEG? Create an account! Log In with myUEG account

UEG Poster

Standard Poster

This content is part of Gutflix. Log in with your myUEG account, or create one free, to watch it.

Not sure what you can access? Learn more about account types.

VALIDATION OF DOMINANT SYMPTOM INTENSITY AS A PATIENT REPORTED OUTCOME MEASURE IN THE EVALUATION OF ESOPHAGEAL SYMPTOMS SUSPICIOUS FOR GASTROESOPHAGEAL REFLUX

Matthew Schroeder 1, Walter Chan 2, Allyson Richardson 2, Neemit Shah 1, Mayssan Muftah 2, Samya Muftah 2, C Prakash Gyawali 1

Affiliations

1 Washington University School Of Medicine, St Louis, United States

2 Brigham and Women's Hospital, Boston, United States

Summary

AI Generated

Summary is not available for this content yet.

Download PDF

Was this helpful?

Thanks for your feedback.

This summary was generated by an AI large language model based on the content transcript. It is for informational purposes only and should not be considered a substitute for clinical judgment. Always rely on your professional expertise and the full clinical context when making clinical decisions.

Abstract

Introduction

Gastroesophageal reflux disease (GERD) presents with typical and atypical symptoms of varying frequency and severity. We compared 5-point Likert scales assessing symptom burden to validated GERD questionnaires, and to outcome following reflux management.

Aims & Methods

We analyzed pooled data from patients undergoing pH-impedance testing for reflux symptoms from two tertiary care centers. All patients completed pre-procedure questionnaires assessing typical (heartburn, regurgitation, esophageal chest pain) and atypical symptoms (cough, belching, wheezing, dysphagia). Symptom severity and frequency were scored on 5-point Likert scales (0=not severe, infrequent; 4=extremely severe, multiple daily episodes); the product of severity and frequency for the highest scoring symptom constituted the dominant symptom intensity (DSI). Patients reported global symptom severity (GSS) on 100 mm visual analog scales (VAS) anchored by 0=no symptoms and 100=severe symptoms. Spearman correlation, general linear regression and receiver operating characteristic (ROC) analyses were performed to compare DSI with validated instruments including GSS, gastroesophageal reflux disease questionnaire (GERDQ) and reflux symptom index (RSI), and pH-impedance parameters per Lyon Consensus 2.0. In a subset, change in DSI after medical and surgical GERD management was compared against symptom burden (GSS) and satisfaction with therapy on 100 mm VAS.

Results

808 patients (mean age 53.8±1.44 years, 65.2% female) were included, 499 (61.8%) with dominant typical symptoms. DSI significantly correlated with GSS (R=0.682), GERDQ (R=0.414), RSI (R=0.577), acid exposure time (AET) (R=0.175), total reflux episodes (R=0.194) and mean nocturnal baseline impedance (R=-0.157)(p<0.0001 for each comparison). DSI remained significantly correlated with GERDQ, GSS, RSI, AET and reflux episodes in both typical and atypical symptom subgroups. Mean DSI was higher with abnormal GERDQ, RSI, and conclusive GERD per Lyon Consensus (p<0.0001 each comparison). On ROC analyses, DSI (AUROC=0.60) was non-inferior to GSS, GERDQ, and RSI in predicting pathologic AET and total reflux episodes, and conclusive GERD. Percentage improvement in DSI after antireflux treatment significantly correlated overall with GSS change (R=0.632, p<0.0001) and treatment satisfaction (R=0.513, p<0.0001), and in both typical and atypical symptom subgroups. On multivariable linear regression analyses, percentage change in DSI remained an independent predictor of GSS change (β=0.302, p<0.0001), and satisfaction with anti-reflux therapy (β=0.833, p=0.011). On ROC analyses, DSI change (AUROC=0.730) was non-inferior to GSS change in predicting satisfaction with therapy.

	Overall	Typical, n=499	Atypical, n=309
Age (years)	53.8±1.44	51.0±2.28	58.2±0.79*
Gender (female)	527 (65.2%)	356 (71.3%)	171 (56.3%)*
Body mass index (kg/m²)	27.4±0.25	27.6±0.32	27.1±0.39
Mean baseline DSI	9.37±0.21	10.6±0.25	7.34±0.33*
Mean baseline GSS	50.1±1.15	60.4±1.28	33.7±1.82*
Mean AET (%)	3.29±0.18	3.63±0.23	2.67±0.26*
Number of reflux events	46.9±1.31	50.3±1.78	40.6±1.62*
MNBI (ohms)	1743±83	1667±106	1864±134
Conclusive GERD	177 (21.9%)	125 (25.1%)	52 (16.8%)

GSS: global symptom severity; AET: acid exposure time; MNBI: mean nocturnal baseline impedance; GERD: gastroesophageal reflux disease;
*p<0.05 compared to typical group

Conclusion

DSI correlates with validated reflux questionnaires, discriminates abnormal from normal reflux burden, and DSI change reflects reflux treatment outcome and satisfaction. DSI is a useful addition to reflux symptom assessment.

Conference

UEG Week Berlin 2025

Topics

Oesophagus

Submission format

Abstract

Session

OESOPHAGEAL, GASTRIC AND DUODENAL (Posters)

Citation

United European Gastroenterology Journal 2025; 13 (Supplement 8)

Published

2025

More Like This:

Unraveling Steatotic Liver Diseases: Insights from Amino Acid and TCA Cycle Metabolomics

Masaaki Mino

Time management: How can we save time?

Deepa Jegadish Gandhi

ANTITHROMBOTIC THERAPY AND UPPER GI HEMORRHAGE: RISKY BUSINESS?

Hassan Seddik

ROLE SWAPPING BETWEEN NURSES AND PHYSICIANS IN SIMULATED ENDOSCOPY TRAINING ENHANCES COLLABORATION AND TEAMWORK: A PROSPECTIVE OBSERVATIONAL PILOT STUDY

Milutin Bulajic

Laudatio UEG Lifetime Achievement Awardee

Mario Dinis-Ribeiro

VALIDATION OF DOMINANT SYMPTOM INTENSITY AS A PATIENT REPORTED OUTCOME MEASURE IN THE EVALUATION OF ESOPHAGEAL SYMPTOMS SUSPICIOUS FOR GASTROESOPHAGEAL REFLUX

C Prakash Gyawali

UEG's educational platform for gastroenterology education bringing recordings, courses, guidelines, and more together in one place.

Most popular content

Rate for better recommendations!

DIRECT HEALTHCARE COSTS OF EOSINOPHILIC ESOPHAGITIS IN THE FIRST YEAR AFTER DIAGNOSIS: A REAL-WORLD ANALYSIS FROM THE EUREOS EOE CONNECT REGISTRY

Unraveling Steatotic Liver Diseases: Insights from Amino Acid and TCA Cycle Metabolomics

Time management: How can we save time?

ANTITHROMBOTIC THERAPY AND UPPER GI HEMORRHAGE: RISKY BUSINESS?

ROLE SWAPPING BETWEEN NURSES AND PHYSICIANS IN SIMULATED ENDOSCOPY TRAINING ENHANCES COLLABORATION AND TEAMWORK: A PROSPECTIVE OBSERVATIONAL PILOT STUDY

Laudatio UEG Lifetime Achievement Awardee

VALIDATION OF DOMINANT SYMPTOM INTENSITY AS A PATIENT REPORTED OUTCOME MEASURE IN THE EVALUATION OF ESOPHAGEAL SYMPTOMS SUSPICIOUS FOR GASTROESOPHAGEAL REFLUX