{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,15]],"date-time":"2026-01-15T02:34:17Z","timestamp":1768444457869,"version":"3.49.0"},"reference-count":30,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2018,1,26]],"date-time":"2018-01-26T00:00:00Z","timestamp":1516924800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Aliment Pharmacol Ther"],"published-print":{"date-parts":[[2018,4]]},"abstract":"Summary<\/jats:title>Background<\/jats:title>Symptom association probability (SAP<\/jats:styled-content>) is thought to distinguish reflux hypersensitivity from functional disorders. A diagnosis of hypersensitive oesophagus (SAP<\/jats:styled-content>\u2010positive) indicates that gastro\u2010oesophageal reflux disease (GERD<\/jats:styled-content>) is the cause of continued symptoms.<\/jats:p><\/jats:sec>Aim<\/jats:title>To conduct an analysis of pH<\/jats:styled-content> and symptom criteria that lead to a diagnosis of SAP<\/jats:styled-content>\u2010positivity<\/jats:p><\/jats:sec>Methods<\/jats:title>We calculated SAP<\/jats:styled-content> for 205 patients with GERD<\/jats:styled-content> symptoms refractory to proton pump inhibitor (PPI<\/jats:styled-content>) therapy who underwent endoscopy with wireless pH<\/jats:styled-content> monitoring from 2007 to 2014. Patients were divided into three groups: pH<\/jats:styled-content>\u2010negative with no oesophagitis (n = 45), pH<\/jats:styled-content>\u2010positive with no oesophagitis (n = 130), and patients with oesophagitis (n = 30). We constructed a 2 \u00d7 2 table of symptom and reflux event association and quantified the number of 2\u2010minute intervals for each of the 2 \u00d7 2 variables that distinguished SAP<\/jats:styled-content>\u2010positive from SAP<\/jats:styled-content>\u2010negative. In a separate cohort of 58 patients who had undergone anti\u2010reflux surgery, we evaluated the effects of pre\u2010surgery SAP.<\/jats:p><\/jats:sec>Results<\/jats:title>The difference in symptom association parameters that led to a diagnosis of an SAP<\/jats:styled-content>\u2010positive was small (2.98% in oesophagitis\u2010positive; 1.56% in oesophagitis\u2010negative\/pH<\/jats:styled-content>\u2010positive; 0.48% in oesophagitis\u2010negative\/pH<\/jats:styled-content>\u2010negative). In the pH<\/jats:styled-content>\u2010negative\/oesophagitis\u2010negative group, a difference of 0.48% led to a diagnosis of hypersensitivity. There was significant variability in SAP<\/jats:styled-content> values between day 1 and day 2 of pH<\/jats:styled-content> testing in all groups, with the greatest in the oesophagitis\u2010positive group, despite objective evidence for reflux (27% in oesophagitis\u2010positive, 19% pH<\/jats:styled-content>\u2010positive\/oesophagitis\u2010negative, and 7% in pH<\/jats:styled-content>\u2010negative\/oesophagitis\u2010negative). Pre\u2010surgery SAP<\/jats:styled-content> was not associated with response to anti\u2010reflux surgery.<\/jats:p><\/jats:sec>Conclusion<\/jats:title>In PPI<\/jats:styled-content>\u2010refractory GERD<\/jats:styled-content>, SAP<\/jats:styled-content> cannot accurately distinguish reflux hypersensitivity from functional oesophageal symptoms.<\/jats:p><\/jats:sec>","DOI":"10.1111\/apt.14528","type":"journal-article","created":{"date-parts":[[2018,1,26]],"date-time":"2018-01-26T06:22:42Z","timestamp":1516947762000},"page":"958-965","source":"Crossref","is-referenced-by-count":20,"title":["Symptom association probability does not reliably distinguish functional heartburn from reflux hypersensitivity"],"prefix":"10.1111","volume":"47","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1717-4472","authenticated-orcid":false,"given":"Y.","family":"Choksi","sequence":"first","affiliation":[{"name":"Division of Gastroenterology, Hepatology and Nutrition Vanderbilt Medical Center Nashville TN USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J. C.","family":"Slaughter","sequence":"additional","affiliation":[{"name":"Department of Biostatistics Vanderbilt Medical Center Vanderbilt University School of Medicine Nashville TN USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"R.","family":"Sharda","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Hepatology and Nutrition Vanderbilt Medical Center Nashville TN USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"T.","family":"Higginbotham","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Hepatology and Nutrition Vanderbilt Medical Center Nashville TN USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"P.","family":"Lal","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Hepatology and Nutrition Vanderbilt Medical Center Nashville TN USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M. F.","family":"Vaezi","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Hepatology and Nutrition Vanderbilt Medical Center Nashville TN USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2018,1,26]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1572-0241.2006.00630.x"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjmed.2010.01.007"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1053\/gast.1996.1101982"},{"key":"e_1_2_7_5_1","first-page":"358","article-title":"The symptom index: a clinically important parameter of ambulatory 24\u2010hour oesophageal pH monitoring","volume":"83","author":"Wiener GJ","year":"1988","journal-title":"Am J Gastroenterol"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/0016-5085(94)90815-X"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2011.07.009"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.23734"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2014.10.028"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2014.08.029"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1053\/gast.2001.24840"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1136\/gut.2005.087668"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1053\/gast.2001.24841"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2016.02.012"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2005.08.060"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1038\/ajg.2012.342"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2016.10.031"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1136\/gut.45.2.172"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2009.02.022"},{"key":"e_1_2_7_20_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1572-0241.2003.07398.x"},{"key":"e_1_2_7_21_1","unstructured":"R Core Team(2016)R: a language and environment for statistical computing.Vienna Austria:R Foundation for Statistical Computing.https:\/\/www.R-project.org\/"},{"key":"e_1_2_7_22_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2008.08.044"},{"key":"e_1_2_7_23_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1572-0241.2006.00936.x"},{"key":"e_1_2_7_24_1","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.5493"},{"key":"e_1_2_7_25_1","doi-asserted-by":"publisher","DOI":"10.1136\/gut.2004.054981"},{"key":"e_1_2_7_26_1","doi-asserted-by":"publisher","DOI":"10.1631\/jzus.B1500027"},{"key":"e_1_2_7_27_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1572-0241.2004.04089.x"},{"key":"e_1_2_7_28_1","doi-asserted-by":"publisher","DOI":"10.1152\/ajpgi.00420.2003"},{"key":"e_1_2_7_29_1","doi-asserted-by":"publisher","DOI":"10.1136\/gut.32.2.128"},{"key":"e_1_2_7_30_1","doi-asserted-by":"publisher","DOI":"10.1038\/ajg.2009.646"},{"key":"e_1_2_7_31_1","doi-asserted-by":"publisher","DOI":"10.1097\/MCG.0b013e3181b8e97b"}],"container-title":["Alimentary Pharmacology & Therapeutics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fapt.14528","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/apt.14528","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,18]],"date-time":"2023-09-18T09:08:33Z","timestamp":1695028113000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/apt.14528"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,1,26]]},"references-count":30,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2018,4]]}},"alternative-id":["10.1111\/apt.14528"],"URL":"https:\/\/doi.org\/10.1111\/apt.14528","archive":["Portico"],"relation":{},"ISSN":["0269-2813","1365-2036"],"issn-type":[{"value":"0269-2813","type":"print"},{"value":"1365-2036","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,1,26]]}}}