The Primary Symptoms of GERD(Gastroesophageal Reflux Disease) in Chinese Outpatients in Gastroenterology Department
Condition: Gastroesophageal Reflux
MeSH terms: Gastroesophageal Reflux; Esophagitis, Peptic
Study type: Observational

Summary: 
      Consecutive patients aged 18-65 years who go to the gastroenterology clinic presented with
      upper gastrointestinal discomfort would be included. All patients underwent upper endoscopy
      or an ambulatory 24-h pH(Potential Of Hydrogen) monitoring.Pathologic esophageal acid reflux
      was defined as the percentage total time for which a pH value < 4 was >4.2 % in the distal
      esophagus. Then, patients were treated with esomeprazole 20 mg twice daily for 28 days. The
      symptom scores were measured by the frequency score multiplied by the severity scores of the
      predominant symptom before and at the end of the treatment, and the " PPI test " was defined
      as positive if the overall scores of the predominant dyspeptic symptom in the fourth week
      decreased by >50 % compared with those of the baseline.

      GERD is defined by either 24-hour impedance-pH monitoring or positive PPI(proton pump
      inhibitor) test or positive result from endoscopy. The percentage of each symptom of GERD in
      the symptom questionnaire in Chinese outpatients in Gastroenterology department will be
      calculated. The symptom of the highest percentage will be the primary symptom.
    

Detailed description: 
      Primary Objective：To define the primary symptom of GERD in Chinese outpatients in
      Gastroenterology department Secondary Objective：1. To investigate the symptom distribution of
      patients who present with symptoms originated from upper gastrointestinal tract and have
      pathologic esophageal reflux established by 24-hour impedance-pH monitoring, upper endoscopy,
      or proton pump inhibitor test.

      2. To evaluate the life quality of patients with atypical GERD symptoms (symptoms except
      heartburning and regurgitation) 3. To investigate the diagnostic value of proton pump
      inhibitor trial to diagnose GERD with atypical reflux symptoms 4. To investigate the
      predictive value of Gerd Q to diagnose GERD with atypical reflux symptoms with heartburn or
      regurgitation
    

Intervention name(s): Esomeprazole MUPS, 20 mg
Intervention type(s): Drug
Intervention description(s): According to the guidelines, the PPI treatment duration would be 8 weeks(Esomeprazole MUPS, 20 mg bid) for patients with reflux esophagitis and 4 weeks (Esomeprazole MUPS, 20 mg bid) for patients with normal findings on endoscopy.
Other intervention name(s): Nexium
Intervention MeSH terms: Esomeprazole
Observational model: Cohort
Time perspective: Prospective
Sampling method: Non-Probability Sample
Study population: 
        The study will be done in the outpatient clinic, department of Gastroenterology, first
        affiliated hospital, sun yet-sen university. Consecutive patients who met the inclusion
        criteria in the Gastroenterology clinic in the first affiliated hospital will be enrolled
        in the study. There will not be any randomization in the study.
      
Keywords: symptom