The Primary Symptoms of GERD(Gastroesophageal Reflux Disease) in Chinese Outpatients in Gastroenterology Department
The Primary Symptoms of GERD(Gastroesophageal Reflux Disease) in Chinese Outpatients in Gastroenterology Department
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.
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
Inclusion Criteria:

 -  Consecutive patients aged 18-65 years who go to the gastroenterology clinic presented
 with upper gastrointestinal discomfort, such as heartburn, regurgitation, dysphagia,
 substernal pain, epigastric pain, epigastric burning, early satiety, postprandial
 fullness.

 -  Whose previous symptoms should last for at least 3 months and be at least 3 days per
 week in frequency with moderate severity.

 -  Able to fill in the questionaires.

 Exclusion Criteria:

 -  gastric or duodenal ulcers, upper GI neoplasms on upper endoscopy

 -  severe cardiac or pulmonary diseases, diabetes or rheumatic diseases

 -  history of operations in the upper GI tract

 -  renal failure or abnormal liver function

 -  use of non-steroidal anti-inflammatory drugs (NSAIDs)

 -  allergy to esomeprazole

 -  Pregnancy or lactating mother