Identifying patients gastroesophageal reflux with a so-called ‘PPI test’ is not effective (Clin Gastroenterol Hepatol 2012; 10: 1360-66).

This study examined data from the previous Diamond study (Gut 2010; 59: 714-21).

In short, among 308 patients who were evaluated by endoscopy and pH probe, 197 had GERD identified by the presence of reflux esophagitis, pH <4 for 5.5% or positive symptom association monitoring.  Then all patients were given esomeprazole 40 mg once a day for two weeks.

A positive response to PPI Rx was observed in 69% of those with GERD and in 51% of those without GERD.  If response was defined as ‘the absence of the most bothersome symptom in the last 3 days of treatment,’ then GERD patients had a 54% response compared to 35% of Non-GERD patients.

While the PPI test is a failure, in many clinical situations, symptom response to therapy may be more important than the reason for the symptoms. The attached link provides a nice synopsis: Study Finds ‘PPI Test’ a Poor Predictor of GERD : Internal Medicine …

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