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Response rate and predictors of response in a short‐term empirical trial of high‐dose rabeprazole in patients with globus
Author(s) -
SINN D. H.,
KIM J. H.,
KIM S.,
SON H. J.,
KIM J. J.,
RHEE J. C.,
RHEE P.L.
Publication year - 2008
Publication title -
alimentary pharmacology and therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.308
H-Index - 177
eISSN - 1365-2036
pISSN - 0269-2813
DOI - 10.1111/j.1365-2036.2008.03659.x
Subject(s) - medicine , reflux , rabeprazole , gastroenterology , proton pump inhibitor , gastro , disease , globus pallidus , basal ganglia , central nervous system
Summary Background Although the aetiology of globus (the sensation of a lump in the throat) remains unclear, gastro‐oesophageal reflux disease is associated with globus. A short‐term trial with a high‐dose proton pump inhibitor has been shown to be a sensitive tool for diagnosing gastro‐oesophageal reflux disease. Aim To see whether patients with globus symptom responded to short‐term high‐dose rabeprazole trial and assess predictors of symptom response. Methods Sixty‐four patients with globus symptom were analysed. Patients received rabeprazole 20 mg b.d. for 14 days. Patients completed a daily diary assessing the severity and frequency of globus. Results Forty‐one patients (64%) were diagnosed clinically with gastro‐oesophageal reflux disease. Based on the pH testing and endoscopy, the prevalence of gastro‐oesophageal reflux disease was 22% (14 of 64). The globus symptom score was significantly higher in patients with gastro‐oesophageal reflux disease compared with patients without gastro‐oesophageal reflux disease ( P = 0.004). Two patients (3%) had complete resolution and 22 (34%) had more than a 50% improvement in the globus symptom score. Endoscopic findings ( P = 0.714), pathological acid exposure on pH testing ( P = 0.741) or baseline gastro‐oesophageal reflux disease symptoms ( P = 0.606) were not associated with improvement of globus symptom. Conclusion While gastro‐oesophageal reflux disease may be an aggravating factor in patients with globus, it does not appear to be the sole cause of globus symptom.