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GERD assessment including pH metry predicts a high response rate to PPI standard therapy.
- Source :
-
BMC Gastroenterology . 2013, Vol. 13 Issue 1, p12-12. 1p. - Publication Year :
- 2013
-
Abstract
- <bold>Background: </bold>Inadequate response to proton pump inhibitor (PPI) therapy in patients with gastroesophageal reflux disease (GERD) is reported in up to 40%. Patients with non erosive reflux disease (NERD) have lower response rates compared to patients with erosive reflux disease (ERD); pH metry contributes to GERD diagnosis and is critical for proper diagnosis of NERD. Aim of the study was to assess the need for doubling esomeprazole standard dose (40 mg) for 4 weeks in PPI naive patients with typical reflux symptoms and diagnosis of GERD based on endoscopy and 48 hours, wireless pH metry.<bold>Methods: </bold>All patients underwent upper GI endoscopy. Symptoms were recorded with a structured questionnaire (RDQ) and acid exposure was determined by 48 hours, wireless pH monitoring (BRAVO). In case of abnormal acid exposure, patients received a short term treatment with esomeprazole 40 mg q.d. for 4 weeks. If symptoms persisted, patients underwent a second pH metry on PPI and the dose was increased to 40 mg b.i.d.<bold>Results: </bold>31 consecutive patients with typical reflux symptoms underwent 48 hours pH monitoring. 22 patients (71%) had abnormal acid exposure, 9 patients had normal pH metry (29%). Of the 9 patients with normal pH metry, 2 were found with erosive esophagitis and 7 without endoscopic abnormalities. 24 patients with documented GERD received esomeprazole treatment. 21 patients achieved complete symptom resolution with 40 mg q.d. after 4 weeks (88%). Only 2 patients required doubling the dose of esomeprazole for complete symptom resolution, 1 patient remained with symptoms.<bold>Conclusions: </bold>Patients with typical reflux symptoms and abnormal acid exposure have a high response rate to standard dose esomeprazole regardless of whether they have ERD or NERD. [ABSTRACT FROM AUTHOR]
Details
- Language :
- English
- ISSN :
- 1471230X
- Volume :
- 13
- Issue :
- 1
- Database :
- Academic Search Index
- Journal :
- BMC Gastroenterology
- Publication Type :
- Academic Journal
- Accession number :
- 104225229
- Full Text :
- https://doi.org/10.1186/1471-230X-13-12