Comparison of risk factors and clinical responses to proton pump inhibitors in patients with erosive oesophagitis and non‐erosive reflux disease

Background/Aims Proton pump inhibitors (PPIs) are widely used in the treatment of gastroesophageal reflux disease (GERD). However, some patients fail to respond to PPI therapy. We investigated the efficacy of response to PPI therapy in patients with GERD symptoms. Methods A total of 179 subjects with GERD symptoms were prospectively enrolled and diagnosed with non-erosive reflux disease (NERD, n = 100) and erosive reflux disease (n = 79) by gastroscopy and Bernstein test and/or 24-hour esophageal pH testing. Subjects then received a standard dose of daily PPI therapy for at least 4 weeks. PPI therapy response was evaluated using questionnaires including questions about demographics, GERD symptoms, GERD impact scale, Epworth sleepiness scale, Pittsburgh sleep quality index (PSQI), hospital anxiety and depression scale, and abbreviated version of the World Health Organization quality of life scale. Results The rates of complete (≥ 80%), satisfactory (≥ 50%), partial (< 50%), and refractory response in the 179 participants were 41.3%, 30.2%, 18.4%, and 10.1%, respectively. Thus, overall response rate (complete and satisfactory responses) was 71.5%. Multivariate analysis showed body mass index < 23 kg/m 2 (OR, 2.20; 95% CI, 1.12–4.34), higher total PSQI score (OR, 1.20; 95% CI, 1.05–1.35), history of psychotherapy or neuropsychiatric medication (OR, 2.44; 95% CI, 1.23–4.85), and NERD (OR, 3.30; 95% CI, 1.54–7.11) were associated with poor response to PPI therapy. Conclusions Psychological factors, sleep dysfunction, body mass index < 23 kg/m 2 , and NERD seem to be the major factors that lead to a poor response to PPI treatment in patients with GERD symptoms.

Section: Questionnairesmentioning

confidence: 99%

Section: Ambulatory 24-hour Esophageal Ph Monitoringmentioning

confidence: 99%

Predictive Factors of Response to Proton Pump Inhibitors in Korean Patients With Gastroesophageal Reflux Disease

Kim

et al. 2015

“…[4][5][6][7][8][9] However, limited data exist on the response to PPI therapy and the recurrence of GERD in East Asian countries, including Korea. [10][11][12][13] Patients with GERD have a decreased health-related quality of life (HRQoL). 12,14,15 Although HRQoL improves with treatment, persistent symptoms after PPI therapy are associated with a reduced HRQoL.…”

Section: Introductionmentioning

confidence: 99%

Recurrence and Its Impact on the Health-related Quality of Life in Patients with Gastroesophageal Reflux Disease: A Prospective Follow-up Analysis

Shin

Cheon

et al. 2015

Background/AimsLimited data exist on the outcome of gastroesophageal reflux disease (GERD) treatment and its impact on the health-related quality of life (HRQoL) in the Asian population. This study aims to evaluate the treatment outcomes, to investigate the factors associated with recurrence, and to evaluate the impact of the treatment outcome on the HRQoL in a Korean GERD population. MethodsThis was a prospective, multicenter study involving a total of 824 GERD patients. The response to treatment was assessed at week 4 (or week 8 for the patients who did not achieve complete resolution [CR] at week 4). The EQ-5D questionnaire was used at baseline, end of treatment, and first recurrence to assess the HRQoL. To assess GERD symptoms, contact of patients by phone at 1, 6, and 12 months following treatment was carried out. ResultsCR was achieved in 65.6% and recurrence was observed in 47.8% following treatment. CR and recurrence rates did not differ by the presence of esophagitis. Multivariate analysis revealed that acid regurgitation (odds ratio 2.249; 95% confidence interval 1.293-3.912; P = 0.004) and both acid regurgitation and heartburn (odds ratio 2.330; 95% confidence interval 1.392-3.901; P = 0.001) were independent risk factors for GERD recurrence. EQ-5D scores were more improved in patients with CR than in those without CR, and worsened more during follow-up in patients with recurrence than in those without recurrence. ConclusionsWe should achieve complete symptom relief and attempt to prevent recurrence in GERD patients to improve their HRQoL.

“…Extraesophageal reflux symptoms and non-erosive reflux disease are more frequent in the East than in the West. [17][18][19][20][21] In addition, the response rate to a proton pump inhibitor is lower in the East than in the West. [22][23][24][25] This kind of interest in the Eastern countries might explain why GERD is the main research topic in Asia.…”

Section: Comparison Of Research Topics Between 2 Neurogastroenterologmentioning

confidence: 99%

Comparing the Areas of Interest in the Field of Functional Gastrointestinal Disorder and Neurogastroenterology and Motility Between the East and the West

Lee

Kim

et al. 2015

There is a paucity of studies that compare the differences in published articles submitted from the East and the West in the area of neurogastroenterology and motility (NM). To compare the article topics from the East and the West which have been published, 5 Western (Gastroenterology, Gut, American Journal of Gastroenterology, American Journal of Physiology-Gastrointestinal and Liver Physiology, and Neurogastroenterology and Motility) and 3 Eastern gastrointestinal journals (Journal of Gastroenterology, Journal of Gastroenterology and Hepatology, and Journal of Neurogastroenterology and Motility) were selected based on the impact factor. Published papers were classified into 12 categories and 60 subcategories. The titles and abstracts of review articles, original articles, and meta-analyses from these journals were reviewed for the last 2 years (2013)(2014). In case of Journal of Neurogastroenterology and Motility which is published quarterly, this search was performed for 5 years (2010)(2011)(2012)(2013)(2014). Of the total 2656 reviewed articles, 842 (260 from the East and 582 from the West) were classified into the category of NM. The most frequently published papers from the Western researchers were categorized as brain-gut interaction, visceral hypersensitivity, and irritable bowel syndrome, whereas those from the Eastern researchers were categorized as gastroesophageal reflux disease, functional dyspepsia, and irritable bowel syndrome. This difference between the East and the West is not just due to the journal itself, but it also depends on the author's affiliation and their ability to perform high quality research in the area of the NM. These data provide evidence for the research trend and give valuable information to the researchers for determining subjects for the study and for selecting proper journals for publishing their studies.