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METHODS

Patients with typical reflux symptoms (heartburn and/or regurgitation) and normal endoscopy (NERD) underwent a combined impedance-pH monitoring off proton pump inhibitor (PPI) therapy. Previously investigated 48 healthy volunteers served as controls. Distal esophageal acid exposure (% time pH< 4), number of acid and nonacid reflux episodes, 2-min window symptom index (SI; positive if≥ 50%), and symptom association probability (SAP; positive if≥ 95%) were calculated.

RESULTS

Between June 2004 and June 2007, 150 NERD patients (82 women, mean age 48 yr, range 18–78 yr) reported symptoms during the impedance-pH monitoring. NERD patients had more reflux episodes (median [25th–75th percentile]) compared with healthy volunteers (total: 46 [26–65] vs 32 [18–43], P< 0.05; acid: 29 [14–43] vs 17 [8.5–31.0], P< 0.05; and nonacid: 20 [15–27] vs 18 [13.5–26.0], P= NS). Sixty-three …