Symptom Diversity of Patients with Reflux Esophagitis: Effect of Omeprazole Treatment

Abstract

Summary Objective: A number of clinical trials have reported that proton-pump inhibitors are efficacious in the treatment of upper abdominal symptoms, but most of these trials have been carried out in Caucasians. This study investigated the type of upper abdominal symptoms reported by Japanese patients with reflux esophagitis and the efficacy of omeprazole for treating their symptoms.Methods: A total of 234 patients aged ≥20 years with grade A to D reflux esophagitis were enrolled in this multicenter, open study. Patients received omeprazole 10 or 20 mg/day for 4 weeks. Symptom and quality of life questionnaires were administered at baseline, week 2 and week 4.Results: Among the 221 evaluable patients, almost 70% reported reflux-type symptoms (e.g. regurgitation and heartburn). Ulcer-and dysmotility-type symptoms (e.g. stomach pain and belching) were also common, occurring in 38-62% of patients. After 4 weeks of omeprazole *To whom correspondence should be addressed. Tel: +81-853-20-2190 Fax: +81-853-20-2187 E-mail: kadachi@med.shimane-u.ac.jp Abbreviations: ARD, acid-related disease; FD, functional dyspepsia; GSRS, Gastrointestinal Symptoms Rating Scale; PPIs, proton pump inhibitors; PU, peptic ulcer; QOL,quality of life; RE, reflux esophagitis; SD, standard deviation. Conclusion: Reflux-type symptoms as well as ulcer-and dysmotility-type symptoms were seen frequently in Japanese patients with reflux esophagitis. However, omeprazole improved all symptom types and quality of life in this patient population.

A Study on the Efficacy of Rebamipide for Patients with Proton Pump Inhibitor-Refractory Non-Erosive Reflux Disease

“…Numbers in parenthesis indicate the % of improved patients were unable to clearly demonstrate the efficacy of rebamipide for control of reflux symptoms in NERD patients who were refractory to PPI therapy. Several investigators have demonstrated that patients with GERD have not only reflux symptoms but also several dyspeptic symptoms, and the dyspeptic symptoms in GERD patients are often improved by PPI administration [33][34][35]. The present results showed that dyspeptic symptoms in patients who had received rebamipide were more frequently improved.…”

Comparison of endoscopic findings with symptom assessment systems (FSSG and QUEST) for gastroesophageal reflux disease in Japanese centres

“…We also achieved similar results for both questionnaires in this direct comparative study, with no differences between the two in regard to sensitivity or specificity. A possible reason for the relatively low specificities for GERD of the two investigated questionnaires in this study might be the difficulty in distinguishing between acid‐reflux‐related symptoms and dyspeptic (dysmotility) symptoms in patients with GERD in Japan, because of the multidimensionality of GERD symptoms and the high proportion of mild disease in Japanese patients 3,27,28 …”

Comparison of the effects of omeprazole and famotidine in treatment of upper abdominal symptoms in patients with reflux esophagitis

“…On the contrary, in Japan it is not known which drug is the first choice in controlling overall symptoms [10]. Adachi et al [11] recently reported symptom diversity in GERD patients, i.e., overlap of subtype symptoms and omeprazole efficacy independent of subtype. We therefore planned a study to investigate the efficacy of PPI compared to treatment with H 2 receptor antagonists for treatment of upper abdominal symptoms in patients with reflux esophagitis.…”