Comparison of endoscopic findings with symptom assessment systems (FSSG and QUEST) for gastroesophageal reflux disease in Japanese centres

J Gastroenterol Hepatol. 2009 Apr;24(4):633-8. doi: 10.1111/j.1440-1746.2008.05747.x. Epub 2009 Jan 12.

Abstract

Background and aim: We compared endoscopic findings of the frequency scale for the symptoms of gastroesophageal reflux disease (FSSG), a written questionnaire developed in Japan, to that for the questionnaire for the diagnosis of reflux esophagitis (QUEST) for the diagnosis of reflux esophagitis.

Methods: We registered 475 patients with untreated symptoms of upper abdominal pain (male/female: 252/223, average age 52.4 +/- 17.8 years). Subjects were assessed first with the FSSG and QUEST questionnaires, then by endoscopy, before allocation to a gastric ulcer (GU), duodenal ulcer (DU), gastroesophageal reflux disease (GERD) or functional dyspepsia (FD) group.

Results: On the basis of the endoscopic findings the diagnoses for the 475 subjects were as follows: FD 52.2%, DU 7.6%, GU 7.8%, and GERD 32.4% (Grade M 10.1%, Grade A + B 20.2%, Grade C + D 2.3%). There was no difference between the FSSG and QUEST in sensitivity, specificity or accuracy for any condition. The FSSG score rose with increasing endoscopic severity of GERD, but there was no correlation between the QUEST score and endoscopic severity. The FSSG total score was inferior to QUEST in terms of distinguishing GERD from other conditions, but when only the questions relating to reflux symptoms were used, the FSSG was able to distinguish GERD from other conditions as well as QUEST.

Conclusions: The FSSG score reflects the severity of the endoscopic findings of GERD.

Publication types

  • Comparative Study
  • Multicenter Study

MeSH terms

  • Abdominal Pain / etiology
  • Abdominal Pain / pathology
  • Adult
  • Aged
  • Duodenal Ulcer / complications
  • Duodenal Ulcer / diagnosis*
  • Duodenal Ulcer / pathology
  • Dyspepsia / complications
  • Dyspepsia / diagnosis*
  • Dyspepsia / pathology
  • Endoscopy, Digestive System*
  • Esophagitis, Peptic / complications
  • Esophagitis, Peptic / diagnosis*
  • Esophagitis, Peptic / pathology
  • Female
  • Gastroesophageal Reflux / diagnosis*
  • Gastroesophageal Reflux / pathology
  • Humans
  • Japan
  • Male
  • Middle Aged
  • Predictive Value of Tests
  • Sensitivity and Specificity
  • Severity of Illness Index
  • Stomach Ulcer / complications
  • Stomach Ulcer / diagnosis*
  • Stomach Ulcer / pathology
  • Surveys and Questionnaires