Pathogenesis of Double-Dose Proton Pump Inhibitor-Resistant Non-Erosive Reflux Disease, and Mechanism of Reflux Symptoms and Gastric Acid Secretion-Suppressive Effect in the Presence or Absence of Helicobacter pylori Infection
| Autor: | Shintaro Hoshino, Yuriko Hanada, Yoshio Hoshihara, Mariko Umezawa, Hirohito Sano, Yoshimasa Hoshikawa, Katsuhiko Iwakiri, Noriyuki Kawami, Nana Takenouchi, Eiji Uchida, Tsutomu Nomura |
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| Rok vydání: | 2017 |
| Předmět: |
medicine.medical_specialty
medicine.drug_class Double dose Mechanism (biology) business.industry Gastroenterology Reflux Proton-pump inhibitor Disease Pathogenesis 03 medical and health sciences 0302 clinical medicine 030220 oncology & carcinogenesis Internal medicine medicine Gastric acid 030211 gastroenterology & hepatology Secretion business |
| Zdroj: | Digestion. 95:140-145 |
| ISSN: | 1421-9867 0012-2823 |
| Popis: | Background: Various mechanisms have been suggested to be responsible for contributing to the occurrence of proton pump inhibitor (PPI)-resistant non-erosive reflux disease (NERD). The aims of this study were to clarify the pathogenesis of PPI-resistant NERD. Methods: Fifty-three patients with NERD, who had persistent reflux symptoms despite taking double-dose PPI, were included in this study. After excluding eosinophilic esophagitis (EoE) and primary esophageal motility disorder, esophageal impedance-pH monitoring was carried out. In symptom index (SI)-positive patients, the mechanism of SI positivity and the percent time with intragastric pH >4 were investigated according to the presence or absence of Helicobacter pylori infection. Results: One of the 53 patients had EoE, and 4 had primary esophageal motility disorder. Twenty-three and 2 patients were SI-positive for liquid and gas-only reflux respectively. Of 17 SI-positive, H. pylori-negative patients, 5 were SI-positive for acid reflux, whereas all of the H. pylori-positive patients were SI-positive for non-acid reflux. The percent time with intragastric pH >4 was significantly lower in the H. pylori-negative patients than in the H. pylori-positive patients. Conclusions: The pathogenesis of double-dose PPI-resistant NERD was identified in 57%. In some of H. pylori-negative patients, acid-related symptoms were observed. However, in H. pylori-positive patients, these symptoms were excluded by taking double-dose PPI. |
| Databáze: | OpenAIRE |
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