Predictors of proton pump inhibitor failure in non-erosive reflux disease: A study with impedance-pH monitoring and high-resolution manometry

Neurogastroenterology and Motility : the Official Journal of the European Gastrointestinal Motility Society
Y ShiY Xiao

Abstract

Approximately one-third of gastroesophageal reflux disease (GERD) patients have symptoms resistant to proton pump inhibitor (PPI). We used the high-resolution manometry (HRM) and multichannel intraluminal impedance-pH (MII-pH) monitoring to investigate potential predictors of PPI failure in non-erosive reflux disease (NERD) patients. One hundred and seventeen NERD patients were included, within which there were 44 PPI failure patients. The symptomatic questionnaire GerdQ, HRM and 24-hour MII-pH monitoring were performed before PPI therapy. PPI failure was defined as persistent reflux symptoms for more than 1 day during the last week on esomeprazole (20 mg twice daily) for continuous 4 weeks. The predictors for PPI failure were investigated by multivariable logistic regression analysis. Proton pump inhibitor failure patients had lower body mass index (BMI) and more concomitant functional dyspepsia (FD) symptoms. PPI failure patients had a higher percentage of type I esophagogastric junction (EGJ) morphology (p = 0.005), increased EGJ augmentation (p = 0.000), higher prevalence of esophageal motility disorders (p = 0.005) and a higher ratio of negative symptom index (SI, p = 0.000). Multivariable regression analysis showed that c...Continue Reading

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Citations

Feb 28, 2017·The Korean journal of gastroenterology = Taehan Sohwagi Hakhoe chi·In Du Jeong
Aug 10, 2020·The American Journal of Gastroenterology·C Prakash GyawaliRena H Yadlapati
Sep 21, 2016·The Korean journal of gastroenterology = Taehan Sohwagi Hakhoe chi·In Du Jeong, Moo In Park
Sep 25, 2020·The Korean journal of gastroenterology = Taehan Sohwagi Hakhoe chi·Jun Young KimPoong-Lyul Rhee
Nov 23, 2021·The American Journal of Gastroenterology·Philip O KatzStuart Jon Spechler

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