Majority of symptoms in esophageal reflux PPI non-responders are not related to reflux

Neurogastroenterology and Motility : the Official Journal of the European Gastrointestinal Motility Society
S RomanJ E Pandolfino

Abstract

Genesis of persistent gastro-esophageal reflux symptoms despite proton pump inhibitor (PPI) therapy is not fully understood. We aimed at determining reflux patterns on 24-h pH-impedance monitoring performed on PPI and correlating impedance patterns and symptom occurrence in PPI non-responders. Seventy-eight PPI non-responder patients underwent 24-h pH-impedance monitoring on PPI. Reflux impedance characterization included gastric and supragastric belches and proximal extent of reflux. Symptoms were considered associated with reflux if occurring within 5 min after a reflux event. Patients were classified into three groups: persistent acid reflux (acid esophageal exposure [AET] >5% of time), reflux sensitivity (AET <5%, symptom index [SI] ≥50%), and functional symptoms (AET <5%, SI <50%). Dominant impedance pattern was determined for each patient. Seven patients (9%) had persistent acid reflux, 28 (36%) reflux sensitivity, and 43 (55%) functional symptoms. A total of 4296 reflux events were identified (median per patient 45 [range 4-221]). Although liquid reflux was the most common pattern in all groups, patients with reflux sensitivity and functional symptoms had much more variability in their pattern profile with a large propor...Continue Reading

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Citations

Sep 14, 2016·Neurogastroenterology and Motility : the Official Journal of the European Gastrointestinal Motility Society·M FrazzoniE Savarino
Sep 21, 2016·The American Journal of Gastroenterology·Nicola de BortoliSantino Marchi
Apr 4, 2017·Neurogastroenterology and Motility : the Official Journal of the European Gastrointestinal Motility Society·S RomanUNKNOWN GERD consensus group
May 26, 2017·Neurogastroenterology and Motility : the Official Journal of the European Gastrointestinal Motility Society·C P GyawaliUNKNOWN International GERD Consensus Working Group
Mar 13, 2018·Alimentary Pharmacology & Therapeutics·T H TaftJ E Pandolfino
Oct 11, 2017·Journal of Neurogastroenterology and Motility·Takahisa Yamasaki, Ronnie Fass
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May 21, 2016·Current Opinion in Gastroenterology·Joanne L S OoiDaniel Sifrim
Apr 8, 2020·Expert Review of Clinical Pharmacology·Vincenzo SavarinoEdoardo Savarino
Feb 14, 2018·Gut·C Prakash GyawaliSabine Roman
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Jun 8, 2018·Alimentary Pharmacology & Therapeutics·A Patel, C P Gyawali
Aug 3, 2020·The American Journal of Gastroenterology·Afrin N KamalAlbert J Bredenoord
Dec 29, 2020·Neurogastroenterology and Motility : the Official Journal of the European Gastrointestinal Motility Society·Frank ZerbibC Prakash Gyawali
Jul 24, 2020·Journal of Neurogastroenterology and Motility·Yuqing LinYinglian Xiao
Jan 13, 2021·Neurogastroenterology and Motility : the Official Journal of the European Gastrointestinal Motility Society·Livia GuadagnoliLaurie Keefer
Mar 10, 2020·Gastrointestinal Endoscopy Clinics of North America·Caroline M BarrettMichael F Vaezi
Mar 17, 2021·Clinics and Research in Hepatology and Gastroenterology·Sabine RomanTiffany Taft
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