PMID- 12658782
OWN - NLM
STAT- MEDLINE
DCOM- 20040809
LR  - 20240202
IS  - 1672-0733 (Print)
IS  - 1672-0733 (Linking)
VI  - 22
IP  - 1
DP  - 2002
TI  - Analysis on the causes for refractory GERD.
PG  - 47-9
AB  - To analyze the causes of failure in conventional treatment to refractory 
      gastroesophageal reflux diseases (GERD) patients, 16 refractory GERD patients 
      (group R) and 16 cases of GERD primarily diagnosed (group P) were studied. 
      Endoscopy, pathologic examination and 14C urea breath test were conducted in 
      every patient. 24 h ambulatory pH and bilirubin monitoring were performed with 
      Digitrapper MK III and Synetics Bilitec 2000. It was found that esophagitis in 
      group R was more severe than in group P. The rate of Helicobacter pylori 
      infection in group R was significantly lower than in group P. Fraction time pH 
      below 4.00 was not longer while the bile reflux represented by fraction time abs 
      above 0.14 was greater for patients in the group R as compared with those in the 
      group P. The mixed refluxes and pure bile refluxes between the two groups had 
      significant difference. The reflux episodes in the group R mainly occurred during 
      nights. These results indicated that severe esophagitis, especially Barrett's 
      esophagus with complications makes it difficult to control GERD. Severe 
      duodenogastroesophageal refluxes (DGER) are often accompanied by refractory GERD. 
      Mixed refluxes aggravate the esophageal injuries. Pure bile refluxes and 
      nocturnal refluxes may cause failure of administration of proton pump inhibitors 
      (PPI) in the morning. Helicobacter pylori infection and acid refluxes may not be 
      the direct cause of refractoriness. Individual refractory GERD patient without 
      abnormal results on pH or bile reflux recently should be diagnosed again.
FAU - Chen, Jie
AU  - Chen J
AD  - Department of Gastroenterology, Xiehe Hospital, Tongji Medical College, Huazhong 
      University of Science and Technology, Wuhan 430022.
FAU - Xu, Junying
AU  - Xu J
FAU - Xu, Yong
AU  - Xu Y
FAU - Xie, Xiaoping
AU  - Xie X
FAU - Yi, Cuiqiong
AU  - Yi C
FAU - Hou, Xiaohua
AU  - Hou X
LA  - eng
PT  - Journal Article
PL  - China
TA  - J Huazhong Univ Sci Technolog Med Sci
JT  - Journal of Huazhong University of Science and Technology. Medical sciences = Hua 
      zhong ke ji da xue xue bao. Yi xue Ying De wen ban = Huazhong keji daxue xuebao. 
      Yixue Yingdewen ban
JID - 101169627
SB  - IM
MH  - Adult
MH  - Barrett Esophagus/complications
MH  - Esophagitis/complications/microbiology
MH  - Female
MH  - Gastroesophageal Reflux/complications/diagnosis/*therapy
MH  - Helicobacter Infections/complications
MH  - Helicobacter pylori
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Treatment Failure
EDAT- 2003/03/28 05:00
MHDA- 2004/08/10 05:00
CRDT- 2003/03/28 05:00
PHST- 2003/03/28 05:00 [pubmed]
PHST- 2004/08/10 05:00 [medline]
PHST- 2003/03/28 05:00 [entrez]
AID - 10.1007/BF02904787 [doi]
PST - ppublish
SO  - J Huazhong Univ Sci Technolog Med Sci. 2002;22(1):47-9. doi: 10.1007/BF02904787.