Influence of the pH Value of Refluxate and Proximal Extent on Heartburn Perception in Patients with Proton Pump Inhibitor-Refractory Non-Erosive Reflux Disease.
Electric Impedance
Esophageal pH Monitoring
Esophagus
/ metabolism
Female
Gastroesophageal Reflux
/ complications
Gastrointestinal Contents
/ chemistry
Heartburn
/ etiology
Humans
Hydrogen-Ion Concentration
Male
Middle Aged
Perception
Proton Pump Inhibitors
/ therapeutic use
Retrospective Studies
Symptom Assessment
Symptom Flare Up
Treatment Failure
Impedance pH monitoring
Proton pump inhibitor
Proton pump inhibitor refractory non-erosive reflux disease
Proximal reflux
pH value
Journal
Digestion
ISSN: 1421-9867
Titre abrégé: Digestion
Pays: Switzerland
ID NLM: 0150472
Informations de publication
Date de publication:
2020
2020
Historique:
received:
27
11
2018
accepted:
01
04
2019
pubmed:
30
7
2019
medline:
17
4
2021
entrez:
30
7
2019
Statut:
ppublish
Résumé
Weakly acidic reflux has been reported as the major cause of symptom occurrence in patients with proton pump inhibitor (PPI)-refractory non-erosive reflux disease (NERD). This study is aimed at clarifying whether the pH value of weakly acidic reflux affects the induction of symptoms. We retrospectively evaluated the records of combined multichannel intraluminal impedance and pH monitoring in 57 patients with PPI-refractory NERD. Weakly acidic refluxes were divided into 3 categories based on the pH value of the refluxate: pH 4-5, 5-6, and 6-7. A total of 29 patients were positive in the symptom index. The symptom provocation rate in reflux of pH 4-5 (19%) was much higher than in that of pH 5-6 (11%) and pH 6-7 (12%). In the reflux at pH 4-5, the symptom provocation rate in the proximal reflux was higher than that in the distal reflux (p < 0.05), whereas the reflux at pH 5-6 and pH 6-7 was not significantly different in the symptom provocation rate between the proximal and distal refluxes. Reflux at pH <5 reaching the proximal esophagus was the main factor in the induced symptoms of patients with PPI-refractory NERD.
Sections du résumé
BACKGROUND AND OBJECTIVES
OBJECTIVE
Weakly acidic reflux has been reported as the major cause of symptom occurrence in patients with proton pump inhibitor (PPI)-refractory non-erosive reflux disease (NERD). This study is aimed at clarifying whether the pH value of weakly acidic reflux affects the induction of symptoms.
METHODS
METHODS
We retrospectively evaluated the records of combined multichannel intraluminal impedance and pH monitoring in 57 patients with PPI-refractory NERD. Weakly acidic refluxes were divided into 3 categories based on the pH value of the refluxate: pH 4-5, 5-6, and 6-7.
RESULTS
RESULTS
A total of 29 patients were positive in the symptom index. The symptom provocation rate in reflux of pH 4-5 (19%) was much higher than in that of pH 5-6 (11%) and pH 6-7 (12%). In the reflux at pH 4-5, the symptom provocation rate in the proximal reflux was higher than that in the distal reflux (p < 0.05), whereas the reflux at pH 5-6 and pH 6-7 was not significantly different in the symptom provocation rate between the proximal and distal refluxes.
CONCLUSION
CONCLUSIONS
Reflux at pH <5 reaching the proximal esophagus was the main factor in the induced symptoms of patients with PPI-refractory NERD.
Identifiants
pubmed: 31357199
pii: 000500133
doi: 10.1159/000500133
doi:
Substances chimiques
Proton Pump Inhibitors
0
Types de publication
Evaluation Study
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
375-381Informations de copyright
© 2019 S. Karger AG, Basel.