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Predicting the efficacy of proton pump inhibitors in patients with non‐erosive reflux disease before therapy using dual‐channel 24‐h esophageal pH monitoring
Author(s) -
Shimatani Tomohiko,
Sugimoto Mitsushige,
Nishino Masafumi,
Adachi Kyoichi,
Furuta Kenji,
Ito Masanori,
Kurosawa Susumu,
Manabe Noriaki,
Mannen Kotaro,
Hongo Michio,
Chiba Tsutomu,
Kinoshita Yoshikazu
Publication year - 2012
Publication title -
journal of gastroenterology and hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.214
H-Index - 130
eISSN - 1440-1746
pISSN - 0815-9319
DOI - 10.1111/j.1440-1746.2011.06975.x
Subject(s) - medicine , reflux , esophageal ph monitoring , gastroenterology , esophageal disease , disease , dual (grammatical number) , gerd , esophagus , art , literature
Background and Aim: We aimed to determine whether reflux‐ and symptom‐related parameters can predict the efficacy of proton pump inhibitors (PPI) in non‐erosive reflux disease (NERD). Methods: Twenty‐seven NERD patients who had experienced heartburn more than once a week within the previous month were enrolled. Intraesophageal pH before therapy was measured simultaneously at 5 and 15 cm above the esophagogastric junction (EGJ) for 24 h. The PPI rabeprazole was administered at a dose of 10 mg once daily for 4 weeks. In the event that heartburn was not relieved, the dose was increased to 10 mg twice daily for an additional 2 weeks, and again to 20 mg twice daily for another 2 weeks. Results: Univariate analysis demonstrated no significant associations between any reflux‐ or symptom‐related parameters at either site and complete heartburn relief after 4 weeks, or cumulative complete heartburn relief after 8 weeks. However, post‐hoc analysis demonstrated more satisfactory heartburn relief after 4 weeks in patients with a high symptom index compared with those with a low symptom index, at 5 cm above the EGJ ( P = 0.009). Cumulative satisfactory heartburn relief after 8 weeks was also greater in patients with a high total number of acid reflux episodes compared with those with a low total number of episodes, at 15 cm above the EGJ ( P = 0.037). Conclusions: Pre‐therapeutic pH monitoring in the lower and mid‐esophagus is useful for predicting the efficacy of PPI in NERD patients.