{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,27]],"date-time":"2026-09-27T13:55:43Z","timestamp":1790517343628,"version":"4.1.0"},"reference-count":17,"publisher":"BMJ","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Gut"],"published-print":{"date-parts":[[1995,2]]},"abstract":"<jats:p>The relation between symptom severity in gastro-oesophageal reflux disease (GORD) and quantitated oesophageal acid reflux is variable. Furthermore, when oesophageal acid exposure lies within the conventional normal range, the cause of the symptoms is unknown. This prospective study evaluated 24 hour ambulatory oesophageal pH profiles in relation to objective symptom scores in 100 dyspeptic patients who were free from ulcer and gall stones. Twenty patients had raised oesophageal acid exposure and reflux symptoms consistent with GORD, and 80 had oesophageal pH profiles within the conventional normal range. Forty four of the 80 had severe or moderate reflux symptoms and were classified as having reflux like functional dyspepsia (RFD); 36 had minimal or absent reflux symptoms, and were categorised as having non-reflux dyspepsia (NFD). While oesophageal pH profiles lay within the conventional normal range in both functional dyspepsia subgroups, patients with RFD had consistently greater acid exposure values as follows: mean (SEM) total oesophageal acid exposure time, RFD 16.2 (2.56) min v NFD 9.05 (2.0) min (p &lt; 0.03); percentage of time with pH &lt; 4, RFD 1.4 (0.2) v NFD 0.8 (0.2) (p &lt; 0.03); DeMeester scores, RFD 12.8 (0.5) v NFD 11.4 (0.4) (p &lt; 0.03). The RFD group had a pain\/reflux event correlation of 23.8 (5.3)% v 8.1 (3.7)% for the NFD group (p &lt; 0.01). This study shows that patients with RFD have oesophageal acid exposure that lies below the diagnostic threshold for GORD, but exceeds that of patients with NFD. The high pain\/reflux event correlation in RFD, suggests that subthreshold oesophageal acid exposure may be associated with troublesome reflux symptoms.<\/jats:p>","DOI":"10.1136\/gut.36.2.189","type":"journal-article","created":{"date-parts":[[2007,9,18]],"date-time":"2007-09-18T17:41:31Z","timestamp":1190137291000},"page":"189-192","source":"Crossref","is-referenced-by-count":48,"title":["Importance of reflux symptoms in functional dyspepsia."],"prefix":"10.1136","volume":"36","author":[{"given":"P K","family":"Small","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M A","family":"Loudon","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"B","family":"Waldron","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D","family":"Smith","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"F C","family":"Campbell","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[1995,2,1]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"953","DOI":"10.1007\/BF01071906","article-title":"Symptomatic gastrooesophageal reflux: incidence and precipitating factors","volume":"21","author":"Nebel, O.T.; Fomes, M.F.; Castell, D.O.","year":"1976","unstructured":"Nebel OT, Fomes MF, Castell DO. Symptomatic gastrooesophageal reflux: incidence and precipitating factors. American Journal of Digestive Diseases 1976; 21: 953-6.","journal-title":"American Journal of Digestive Diseases"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"205","DOI":"10.1016\/0140-6736(90)90287-F","article-title":"Symptoms in gastro-oesophageal reflux disease","volume":"335","author":"Klauser, A.G.; Schindlbeck, N.E.; Muller-Lissner, S.A.","year":"1990","unstructured":"Klauser AG, Schindlbeck NE, Muller-Lissner SA. Symptoms in gastro-oesophageal reflux disease. Lancet 1990; 335: 205-8.","journal-title":"Lancet"},{"key":"ref_3","first-page":"362","article-title":"Is long term esophageal pH monitoring of clinical value?","volume":"84","author":"Klauser, A.G.; Heinrich, C.; Schindlbeck, N.E.; Muller-Lissner, S.A.","year":"1989","unstructured":"Klauser AG, Heinrich C, Schindlbeck NE, Muller-Lissner SA. Is long term esophageal pH monitoring of clinical value? Am J Gastroenterol 1989; 84: 362-5.","journal-title":"Am J Gastroenterol"},{"key":"ref_4","first-page":"1127","article-title":"Ambulatory 24-hour esophageal pH monitoring, reproducibility and variability of pH parameters","author":"Wiener, G.J.; Morgan, T.M.; Copper, J.B.; Wu, W.C.; Castell, D.O.; Sinclair, J.W.","year":"1988","unstructured":"Wiener GJ, Morgan TM, Copper JB, Wu WC, Castell DO, Sinclair JW, et al. Ambulatory 24-hour esophageal pH monitoring, reproducibility and variability of pH parameters. Dig Dis Sci 1988; 33 (9): 1127-33.","journal-title":"Dig Dis Sci"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"71","DOI":"10.1007\/BF01536157","article-title":"Reliability of 24-hour home oesophageal pH monitoring in diagnosis of gastro-oesophageal reflux","volume":"34","author":"Mattioli, S.; Pilott, V.; Spangaro, M.; Grigioni, W.F.; Zannoli, R.; Felice, V.","year":"1989","unstructured":"Mattioli S, Pilott V, Spangaro M, Grigioni WF, Zannoli R, Felice V, et al. Reliability of 24-hour home oesophageal pH monitoring in diagnosis of gastro-oesophageal reflux. Dig Dis Sci 1989; 34: 71-8.","journal-title":"Dig Dis Sci"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1145","DOI":"10.1136\/gut.28.9.1145","article-title":"Ambulatory 24 hour intra-oesophageal pH-monitoring in the diagnosis of gastro-oesophageal reflux disease","volume":"28","author":"Johnsson, F.; Joelsson, B.; Isberg, P.-E.","year":"1987","unstructured":"Johnsson F, Joelsson B, Isberg P-E. Ambulatory 24 hour intra-oesophageal pH-monitoring in the diagnosis of gastro-oesophageal reflux disease. Gut 1987; 28: 1145-50.","journal-title":"Gut"},{"key":"ref_7","first-page":"1102","article-title":"Ambulatory 2-H oesophageal pH monitoring: normal values, optimal thresholds, specificity sensitivity and reproducibility","volume":"87","author":"Jamieson, JR, Stein; HJ, DeMeester; TR, Bonavina; L, Schwizer; W, Hinder; A.R.","year":"1992","unstructured":"Jamieson JR, Stein HJ, DeMeester TR, Bonavina L, Schwizer W, Hinder AR, et al. Ambulatory 2-H oesophageal pH monitoring: normal values, optimal thresholds, specificity sensitivity and reproducibility. AmJY Gastroenterol 1992; 87: 1102-11.","journal-title":"AmJY Gastroenterol"},{"key":"ref_8","first-page":"576","article-title":"Management of dyspepsia: report of a working party","volume":"i:","author":"Colin-Jones, D.G.","year":"1988","unstructured":"Colin-Jones DG. Management of dyspepsia: report of a working party. Lancet 1988; i: 576-9.","journal-title":"Lancet"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"246","DOI":"10.1136\/gut.32.3.246","article-title":"Evidence for hypomotility in non-ulcer dyspepsia: a prospective multifactorial study","volume":"32","author":"Waldron, B.; Cullen, P.T.; Kumar, R.; Smith, D.; Jankowski, J.; Hopwood, D.","year":"1991","unstructured":"Waldron B, Cullen PT, Kumar R, Smith D, Jankowski J, Hopwood D, et al. Evidence for hypomotility in non-ulcer dyspepsia: a prospective multifactorial study. Gut 1991; 32: 246-51.","journal-title":"Gut"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"15","DOI":"10.3109\/00365528509103928","article-title":"Registration of pain in a psychological perspective","volume":"109","author":"Bates, S.; Sjoden, P.-O.","year":"1985","unstructured":"Bates S, Sjoden P-O. Registration of pain in a psychological perspective. Scand J Gastroenterol 1985; 20 (suppl 109); 15-8.","journal-title":"Scand J Gastroenterol"},{"key":"ref_11","first-page":"686","article-title":"Computerised 24-hour oesophageal pH monitoring: a new ambulatory technique using radiotelemetry","volume":"105","author":"Vitale, G.C.; Sadek, S.; Tulley, F.M.; Rimmer, A.R.; Hunter, B.E.; Phelan, J.; Cuschieri, A.","year":"1985","unstructured":"Vitale GC, Sadek S, Tulley FM, Rimmer AR, Hunter BE, Phelan J, Cuschieri A. Computerised 24-hour oesophageal pH monitoring: a new ambulatory technique using radiotelemetry. J Lab Clin Med 1985; 105: 686-93.","journal-title":"J Lab Clin Med"},{"key":"ref_12","first-page":"724","article-title":"Computerised 24-hour ambulatory oesophageal monitoring and esophagogastroduodenoscopy in the reflux patient","author":"Vitale, G.C.; Cheadle, W.G.; Sadek, S.; Michel, M.E.; Cuschieri, A.","year":"1984","unstructured":"Vitale GC, Cheadle WG, Sadek S, Michel ME, Cuschieri A. Computerised 24-hour ambulatory oesophageal monitoring and esophagogastroduodenoscopy in the reflux patient. Ann Surg 1984; 200: 724-8."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"52","DOI":"10.1097\/00004836-198606001-00008","article-title":"Development of the 24-hour intra-oesophageal pH monitoring composite scoring system","volume":"1","author":"Johnson, L.F.; DeMeester, T.R.","year":"1986","unstructured":"Johnson LF, DeMeester TR. Development of the 24-hour intra-oesophageal pH monitoring composite scoring system. 7 Clin Gastroenterol 1986; suppl 1: 52-8.","journal-title":"7 Clin Gastroenterol"},{"key":"ref_14","first-page":"629","article-title":"Ambulatory esophageal pH recording in gastroesophageal reflux: Relevance to the development of esophagitis","volume":"83","author":"Rokkas, T.; Sladen, G.E.","year":"1988","unstructured":"Rokkas T, Sladen GE. Ambulatory esophageal pH recording in gastroesophageal reflux: Relevance to the development of esophagitis. AmJr Gastroenterol 1988; 83: 629-32.","journal-title":"AmJr Gastroenterol"},{"key":"ref_15","first-page":"1094","article-title":"Scintigraphy in gastroesophageal reflux disease: A comparison to endoscopy, LESp, and 24-H pH score, as well as to simultaneous pH monitoring","volume":"87","author":"Shay, S.S.; Abreu, S.H.; Tsuchida, A.","year":"1992","unstructured":"Shay SS, Abreu SH, Tsuchida A. Scintigraphy in gastroesophageal reflux disease: A comparison to endoscopy, LESp, and 24-H pH score, as well as to simultaneous pH monitoring. Am J Gastroenterol 1992; 87: 1094-101.","journal-title":"Am J Gastroenterol"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"1232","DOI":"10.1016\/S0140-6736(87)92686-9","article-title":"The irritable oesophagus - a frequent cause of angina-like pain","volume":"i:","author":"Vantrappen, G.; Janssens, J.; Ghillebert, G.","year":"1987","unstructured":"Vantrappen G, Janssens J, Ghillebert G. The irritable oesophagus - a frequent cause of angina-like pain. Lancet 1987; i: 1232-4.","journal-title":"Lancet"},{"key":"ref_17","first-page":"231","article-title":"Relationship between gastro-oesophageal reflux and symptoms in patients referred for ambulatory pH monitoring. _rournal of Gastrointestinal Motility","volume":"4","author":"Howard, P.J.; Pryde, A.; Heading, R.C.","year":"1990","unstructured":"Howard PJ, Pryde A, Heading RC. Relationship between gastro-oesophageal reflux and symptoms in patients referred for ambulatory pH monitoring. _rournal of Gastrointestinal Motility 1990; 4: 231-9."}],"container-title":["Gut"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/gut.36.2.189","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,21]],"date-time":"2025-11-21T17:11:44Z","timestamp":1763745104000},"score":1,"resource":{"primary":{"URL":"https:\/\/gut.bmj.com\/lookup\/doi\/10.1136\/gut.36.2.189"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[1995,2]]},"references-count":17,"journal-issue":{"issue":"2","published-online":{"date-parts":[[1995,2,1]]},"published-print":{"date-parts":[[1995,2]]}},"alternative-id":["10.1136\/gut.36.2.189"],"URL":"https:\/\/doi.org\/10.1136\/gut.36.2.189","relation":{},"ISSN":["0017-5749","1468-3288"],"issn-type":[{"value":"0017-5749","type":"print"},{"value":"1468-3288","type":"electronic"}],"subject":[],"published":{"date-parts":[[1995,2]]}}}