Characteristics of Symptomatic Reflux Episodes in Patients with Non-Erosive Reflux Disease Who Have a Positive Symptom Index on Proton Pump Inhibitor Therapy
| Autor: | Noriyuki Kawami, Tsutomu Nomura, Yuriko Tanaka, Masao Miyashita, Seiji Futagami, Hirohito Sano, Mariko Umezawa, Katsuhiko Iwakiri, Yoshio Hoshihara, Choitsu Sakamoto |
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| Rok vydání: | 2010 |
| Předmět: |
Adult
Male Impedance–pH monitoring medicine.medical_specialty Esophageal pH Monitoring Nerd medicine.drug_class Rabeprazole Proton-pump inhibitor Disease Gastroenterology 2-Pyridinylmethylsulfinylbenzimidazoles Heartburn Internal medicine medicine Humans Aged medicine.diagnostic_test business.industry digestive oral and skin physiology Reflux Proton Pump Inhibitors Middle Aged digestive system diseases Ambulatory Gastroesophageal Reflux Female Perception Esophageal pH monitoring business medicine.drug |
| Zdroj: | Digestion. 82:156-161 |
| ISSN: | 1421-9867 0012-2823 |
| Popis: | Background and Aim: The reason that some reflux episodes evoke symptoms is poorly understood, therefore the aim of this study is to assess the determinants of reflux perception in patients with non-erosive reflux disease (NERD) on proton pump inhibitor (PPI) therapy. Methods: Ten NERD patients with persistent symptoms, despite double-dose PPI therapy, were included in this study. All patients had a positive symptom index (SI), which was determined by ambulatory 24-hour combined impedance-pH monitoring. Reflux episodes were identified and classified as acid, weakly acidic or weakly alkaline reflux and were considered symptomatic if patients recorded a symptom within 5 min after a reflux episode. Results: A total of 954 liquid reflux episodes were detected, including 135 (14.2%) acid, 782 (82.0%) weakly acidic, and 37 (3.9%) weakly alkaline. Overall, 59 (6.2%) reflux episodes were symptomatic and the majority (88.1%) of symptomatic reflux episodes were weakly acidic reflux. When reflux episodes were confined to the distal esophagus, there were very few reflux symptoms. Proximal reflux is significantly more likely to be associated with reflux symptoms, irrespective of the acidity of the refluxate or the duration of proximal reflux episodes. Conclusions: In NERD patients who have a positive SI on double-dose PPI therapy, the high proximal extent of refluxate is a major factor associated with reflux perception. |
| Databáze: | OpenAIRE |
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