Influence of the pH Value of Refluxate and Proximal Extent on Heartburn Perception in Patients with Proton Pump Inhibitor-Refractory Non-Erosive Reflux Disease

Yasuaki Abe, Tomoyuki Koike, Masahiro Saito, Tomoki Okata, Kazuaki Norita, Hiroki Kikuchi, Kenichiro Nakagawa, Waku Hatta, Kiyotaka Asanuma, Kaname Uno, Naoki Asano, Akira Imatani, Tooru Shimosegawa, Atsushi Masamune

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Background and Objectives: 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: 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: 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: Reflux at pH <5 reaching the proximal esophagus was the main factor in the induced symptoms of patients with PPI-refractory NERD.

Original languageEnglish
Pages (from-to)375-381
Number of pages7
JournalDigestion
Volume101
Issue number4
DOIs
Publication statusPublished - 2020 Jul 1

ASJC Scopus subject areas

  • Gastroenterology

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