Impact of Pantoprazole on Duodeno-Gastro-Esophageal Reflux (DGER)

Kunsch, Steffen; Neeße, Albrecht; Linhart, T; Steinkamp, Martin; Fensterer, Heiko; Adler, G.; Gress, Thomas M.; Ellenrieder, Volker

doi:10.1055/s-2008-1027865

Cited by 5 publications

(7 citation statements)

References 32 publications

(34 reference statements)

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“…single-dose vs. high-dose pantoprazole) [15,21]. A previous study from our group has shown that only in about 50% of patients with combined pathological reflux (bile and acid) DGER could be normalized by high-dose pantoprazole [19]. Here, we compare the degree of DGER and esophageal acid exposure in a cohort of GERD patients who had a history of incomplete symptom control with PPIs during the past year.…”

Section: Discussionmentioning

confidence: 99%

“…The catheter was introduced nasally and positioned 5 cm above the lower esophageal sphincter. An episode of acid reflux was defined as a decrease in esophageal pH value below 4 for at least 10 s. A pathological pH measurement was defined for a time with pH values below 4 for longer than 4% of the total 24-hour period [15,19]. …”

Section: Methodsmentioning

confidence: 99%

“…A symptom episode of DGER was defined as an increase in esophageal bilirubin OD to 0.14 for at least 10 s. Pathological values were defined for a time with an OD above 0.14 for longer than 4.6% of the total 24-hour period. A specialized diet was prescribed to exclude an interference with DGER measurement [15,19]. …”

Section: Methodsmentioning

confidence: 99%

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Prospective Evaluation of Duodenogastroesophageal Reflux in Gastroesophageal Reflux Disease Patients Refractory to Proton Pump Inhibitor Therapy

Kunsch¹,

Neeße²,

Linhart³

et al. 2012

Digestion

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Background: Duodenogastroesophageal reflux (DGER) is considered an independent risk factor for complicated reflux disease (gastroesophageal reflux disease; GERD). However, the role of DGER in GERD patients refractory to proton pump inhibitors (PPI) remains poorly understood. Methods: 85 patients with clinical reflux symptoms and a history of ineffective response to PPIs were enrolled in the study. Patients with elevated reflux measurement (pH and/or Bilitec measurement; n = 47) received pantoprazole 80 mg for 8 weeks. Clinical outcome was defined as response (≤2 symptoms/week) or nonresponse (≥3 symptoms/week). Results: Of the 47 patients with elevated reflux measurement, 30 were classified as responders and 17 as nonresponders. Treatment with pantoprazole resulted in a significant reduction of acidic reflux in both PPI responders and PPI nonresponders. In contrast, DGER was only significantly reduced in the PPI responder group (22.8 ± 22.8 vs. 6.6 ± 10.8%; p < 0.05) but not in the PPI nonresponder group (24.5 ± 18.6 vs. 22.2 ± 12.7%; p > 0.05). Conclusions: The presented study firstly describes that nonresponsiveness to PPI is associated with a limited effect of PPIs on reducing DGER. Thus, persistent DGER may play a key role in mediating reflux symptoms refractory to high-dose PPIs.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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Prospective Evaluation of Duodenogastroesophageal Reflux in Gastroesophageal Reflux Disease Patients Refractory to Proton Pump Inhibitor Therapy

Kunsch¹,

Neeße²,

Linhart³

et al. 2012

Digestion

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“…Thirteen studies evaluated the treatment of bile reflux (Table 6). The therapies included nine evaluating PPIs, 29‐37 two studies evaluating prokinetics, 38,39 one study evaluating surgery, 29 one evaluating histamine receptor antagonists 40 and one evaluating baclofen 41 . Ten studies utilised Bilitec 2000 as the device to measure bile reflux, three studies used a sodium ion electrode.…”

Section: Resultsmentioning

confidence: 99%

Systematic review: duodenogastroesophageal (biliary) reflux prevalence, symptoms, oesophageal lesions and treatment

Basnayake

Geeraerts

Pauwels

et al. 2021

Aliment Pharmacol Ther

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Summary Background The prevalence of duodenogastroesophageal reflux (DGER) and its effect on symptoms and oesophageal lesions in gastroesophageal reflux disease (GERD) is unclear. Aims To conduct a systematic review to determine the prevalence of DGER among patients with GERD, the effect of DGER on symptoms and oesophageal lesions, and the treatment of DGER. Methods We searched Pubmed and MEDLINE for full text, English language articles until October 2020 that evaluated DGER prevalence among patients with GERD, the effect of DGER on symptoms and oesophageal lesions, and the treatment of DGER. Results We identified 3891 reports and included 35 which analysed DGER prevalence in GERD, 15 which evaluated its effect in non‐erosive reflux disease (NERD), 17 on erosive oesophagitis, 23 in Barrett's, and 13 which evaluated the treatment of DGER. The prevalence of DGER, when evaluated by Bilitec, among all GERD patients ranged from 10% to 97%, in NERD 10%‐63%, in erosive oesophagitis 22%‐80% and in Barrett's 50%‐100%. There were no differences in the presence or degree of DGER among patients who were asymptomatic or symptomatic on proton pump inhibitors (PPI). The most commonly evaluated treatments for DGER were PPIs and DGER reduced post‐PPI therapy in all studies. Conclusions The prevalence of DGER increased with more advanced oesophageal lesions and did not explain persisting symptoms among patients taking PPI therapy. PPIs appear to be effective in the treatment of DGER. DGER remains an important consideration in patients with GERD and future therapies deserve more study.

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“…All patients were referred to the out‐patients department of the University of Marburg for suspected reflux disease. The pattern of clinical symptoms was evaluated with a questionnaire, specifically designed by our group 33 . The symptoms heartburn, regurgitation, chest pain, dysphagia, nocturnal coughing, wheezing, hoarseness and vomiting were graded according to severity into 1: not existing, 2: mild, 3: moderate and 4: severe.…”

Section: Methodsmentioning

confidence: 99%

Combined lung‐sound and reflux‐monitoring: a pilot study of a novel approach to detect nocturnal respiratory symptoms in gastro‐oesophageal reflux disease

Kunsch

Groß²,

Neeße

et al. 2011

Aliment Pharmacol Ther

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Impact of Pantoprazole on Duodeno-Gastro-Esophageal Reflux (DGER)

Cited by 5 publications

References 32 publications

Prospective Evaluation of Duodenogastroesophageal Reflux in Gastroesophageal Reflux Disease Patients Refractory to Proton Pump Inhibitor Therapy

Prospective Evaluation of Duodenogastroesophageal Reflux in Gastroesophageal Reflux Disease Patients Refractory to Proton Pump Inhibitor Therapy

Systematic review: duodenogastroesophageal (biliary) reflux prevalence, symptoms, oesophageal lesions and treatment

Combined lung‐sound and reflux‐monitoring: a pilot study of a novel approach to detect nocturnal respiratory symptoms in gastro‐oesophageal reflux disease

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