{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,29]],"date-time":"2025-10-29T03:41:58Z","timestamp":1761709318005,"version":"3.37.3"},"reference-count":30,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2017,3,20]],"date-time":"2017-03-20T00:00:00Z","timestamp":1489968000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"AstraZeneca Gothenburg"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Aliment Pharmacol Ther"],"published-print":{"date-parts":[[2017,5]]},"abstract":"<jats:title>Summary<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>The diagnosis of gastro\u2010oesophageal reflux disease (<jats:styled-content style=\"fixed-case\">GERD<\/jats:styled-content>) in clinical practice is limited by the sensitivity and specificity of symptoms and diagnostic testing.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aim<\/jats:title><jats:p>To determine if adding histology as a criterion and excluding patients with epigastric pain enhances the diagnosis for <jats:styled-content style=\"fixed-case\">GERD<\/jats:styled-content>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Patients with frequent upper gastrointestinal symptoms who had not taken a proton pump inhibitor in the previous 2 months and who had evaluable distal oesophageal biopsies were included (Diamond study: <jats:styled-content style=\"fixed-case\">NCT<\/jats:styled-content>00291746). Epithelial hyperplasia was identified when total epithelial thickness was at least 430 \u03bcm. Investigation\u2010based <jats:styled-content style=\"fixed-case\">GERD<\/jats:styled-content> criteria were: presence of erosive oesophagitis, pathological oesophageal acid exposure and\/or positive symptom\u2013acid association probability. Symptoms were assessed using the Reflux Disease Questionnaire and a pre\u2010specified checklist.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Overall, 127 (55%) of the 231 included patients met investigation\u2010based <jats:styled-content style=\"fixed-case\">GERD<\/jats:styled-content> criteria and 195 (84%) met symptom\u2010based criteria. Epithelial hyperplasia was present in 89 individuals, of whom 61 (69%) met investigation\u2010based criteria and 83 (93%) met symptom\u2010based criteria. Adding epithelial hyperplasia as a criterion increased the number of patients diagnosed with <jats:styled-content style=\"fixed-case\">GERD<\/jats:styled-content> on investigation by 28 [12%; number needed to diagnose (<jats:styled-content style=\"fixed-case\">NND<\/jats:styled-content>): 8], to 155 (67%). The proportion of patients with a symptom\u2010based <jats:styled-content style=\"fixed-case\">GERD<\/jats:styled-content> diagnosis who met investigation\u2010based criteria including epithelial hyperplasia was significantly greater when concomitant epigastric pain was absent than when it was present (<jats:italic>P<\/jats:italic> &lt; 0.05; <jats:styled-content style=\"fixed-case\">NND<\/jats:styled-content>: 8).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Histology increases diagnosis of <jats:styled-content style=\"fixed-case\">GERD<\/jats:styled-content> and should be performed when clinical suspicion is high and endoscopy is negative. Excluding patients with epigastric pain enhances sensitivity for the diagnosis of <jats:styled-content style=\"fixed-case\">GERD<\/jats:styled-content>.<\/jats:p><\/jats:sec>","DOI":"10.1111\/apt.14028","type":"journal-article","created":{"date-parts":[[2017,3,20]],"date-time":"2017-03-20T09:18:49Z","timestamp":1490001529000},"page":"1350-1357","source":"Crossref","is-referenced-by-count":14,"title":["Diagnosis of gastro\u2010oesophageal reflux disease is enhanced by adding oesophageal histology and excluding epigastric pain"],"prefix":"10.1111","volume":"45","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3765-9111","authenticated-orcid":false,"given":"N.","family":"Vakil","sequence":"first","affiliation":[{"name":"University of Wisconsin School of Medicine and Public Health Madison WI USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M.","family":"Vieth","sequence":"additional","affiliation":[{"name":"Klinikum Bayreuth Bayreuth Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"B.","family":"Wernersson","sequence":"additional","affiliation":[{"name":"AstraZeneca Gothenburg M\u00f6lndal Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J.","family":"Wissmar","sequence":"additional","affiliation":[{"name":"AstraZeneca Gothenburg M\u00f6lndal Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J.","family":"Dent","sequence":"additional","affiliation":[{"name":"Royal Adelaide Hospital and University of Adelaide Adelaide SA Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2017,3,20]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1136\/gut.2009.200063"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1572-0241.2006.00630.x"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2008.08.044"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2016.06.018"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1177\/2050640614532458"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1038\/ajg.2013.89"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1177\/2050640615599716"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1136\/gut.45.2.172"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1442-2050.2007.00678.x"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10620-011-1624-z"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/0016-5085(94)90815-X"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1186\/1477-7525-6-31"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1572-0241.2001.03451.x"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2036.2007.03271.x"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2016.02.011"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2036.2007.03409.x"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1572-0241.2006.00751.x"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.1136\/gut.39.2.151"},{"key":"e_1_2_7_20_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1572-0241.2005.50209.x"},{"key":"e_1_2_7_21_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1572-0241.2005.40978.x"},{"key":"e_1_2_7_22_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00428-008-0704-8"},{"key":"e_1_2_7_23_1","doi-asserted-by":"publisher","DOI":"10.1159\/000080323"},{"key":"e_1_2_7_24_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2036.2003.01713.x"},{"key":"e_1_2_7_25_1","doi-asserted-by":"publisher","DOI":"10.1007\/s004280050032"},{"key":"e_1_2_7_26_1","doi-asserted-by":"publisher","DOI":"10.1111\/apt.12428"},{"key":"e_1_2_7_27_1","doi-asserted-by":"publisher","DOI":"10.1038\/ajg.2009.631"},{"key":"e_1_2_7_28_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00535-012-0672-2"},{"key":"e_1_2_7_29_1","doi-asserted-by":"publisher","DOI":"10.1136\/gut.2003.033290"},{"key":"e_1_2_7_30_1","doi-asserted-by":"publisher","DOI":"10.1038\/ajg.2016.256"},{"key":"e_1_2_7_31_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2016.02.012"}],"container-title":["Alimentary Pharmacology &amp; Therapeutics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fapt.14028","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/apt.14028","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,24]],"date-time":"2023-09-24T09:36:20Z","timestamp":1695548180000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/apt.14028"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,3,20]]},"references-count":30,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2017,5]]}},"alternative-id":["10.1111\/apt.14028"],"URL":"https:\/\/doi.org\/10.1111\/apt.14028","archive":["Portico"],"relation":{},"ISSN":["0269-2813","1365-2036"],"issn-type":[{"type":"print","value":"0269-2813"},{"type":"electronic","value":"1365-2036"}],"subject":[],"published":{"date-parts":[[2017,3,20]]}}}