What is the origin of the DeMeester score?

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Last updated: February 20, 2025View editorial policy

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From the Research

The DeMeester score was developed by Dr. Tom DeMeester and colleagues in the 1970s to quantify acid reflux severity, as noted in studies such as 1 and others, which have consistently referenced its origin and application in the field of gastroesophageal reflux disease (GERD) diagnosis and treatment. The score combines several measurements from 24-hour esophageal pH monitoring into a single numerical score, providing a standardized method for interpreting pH monitoring results and guiding treatment decisions for GERD. Specifically, the score incorporates six components:

  • Total percent time pH < 4
  • Percent time pH < 4 in upright position
  • Percent time pH < 4 in supine position
  • Number of reflux episodes
  • Number of reflux episodes lasting > 5 minutes
  • Duration of longest reflux episode A score above 14.72 is considered abnormal and indicative of pathological acid reflux, as discussed in studies like 2, which highlights the importance of the DeMeester score in diagnosing GERD and distinguishing it from other conditions. The DeMeester score remains widely used today, although newer parameters like impedance testing have been developed to provide additional insights into reflux patterns, as mentioned in studies such as 3, which compares the predictive accuracy of acid exposure time with the DeMeester score in diagnosing gastroesophageal reflux-induced cough. However, the most recent and highest quality study, 3, suggests that acid exposure time may be equivalent to the DeMeester score in diagnosing GERD, but the DeMeester score's role in guiding treatment decisions and its widespread use make it a crucial tool in the management of GERD, as emphasized by studies like 4 and 5, which discuss the correlation between subjective and objective measures of GERD severity and the impact of laparoscopic Nissen fundoplication on symptoms.

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