Characteristics of symptomatic reflux episodes in Japanese proton pump inhibitor-refractory non-erosive reflux disease patients

Kenichiro Nakagawa, Tomoyuki Koike, Katsunori Iijima, Masahiro Saito, Hiroki Kikuchi, Waku Hatta, Nobuyuki Ara, Kaname Uno, Naoki Asano, Tooru Shimosegawa

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

AIM: To clarify the pathogenesis of gastroesophageal reflux disease symptoms in non-erosive reflux disease (NERD) patients. METHODS: Thirty-five NERD patients with persistent symptoms, despite taking rabeprazole 10 mg twice daily for at least 8 wk, were included in this study. All patients underwent 24 h combined impedance - pH on rabeprazole. The symptom index (SI) was considered to be positive if ≥ 50%, and proximal reflux episodes were determined when reflux reached 15 cm above the proximal margin of the lower esophageal sphincter. RESULTS: In 14 (40%) SI-positive patients, with liquid weakly acid reflux, the occurrence rate of reflux symptoms was significantly more frequent in proximal reflux episodes (46.7%) than in distal ones (5.7%) (P < 0.001). With liquid acid reflux, there were no significant differences in the occurrence rate of reflux symptoms between proximal reflux episodes (38.5%) and distal ones (20.5%) (NS). With mixed liquid-gas weakly acid reflux, the occurrence rate of reflux symptoms in proximal reflux episodes was significantly more frequent (31.0%) than in distal reflux ones (3.3%) (P < 0.001). With mixed liquid-gas acid reflux, there were no significant differences in the occurrence rate of reflux symptoms between proximal reflux episodes (29.4%) and distal ones (14.3%) (NS). CONCLUSION: The proximal extent of weakly acidic liquid and mixed liquid-gas reflux is a major factor associated with reflux perception in SI-positive patients on proton pump inhibitor therapy.

Original languageEnglish
Pages (from-to)13352-13359
Number of pages8
JournalWorld Journal of Gastroenterology
Volume21
Issue number47
DOIs
Publication statusPublished - 2015 Dec 21

Keywords

  • Impedance-pH monitoring
  • Non-erosive reflux disease
  • Proton pump inhibitor
  • Proximal reflux
  • Symptomatic reflux episodes

ASJC Scopus subject areas

  • Gastroenterology

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