PMID- 19434361
OWN - NLM
STAT- MEDLINE
DCOM- 20090824
LR  - 20221207
IS  - 0944-1174 (Print)
IS  - 0944-1174 (Linking)
VI  - 44
IP  - 7
DP  - 2009
TI  - Acid and non-acid reflux in Japanese patients with non-erosive reflux disease 
      with persistent reflux symptoms, despite taking a double-dose of proton pump 
      inhibitor: a study using combined pH-impedance monitoring.
PG  - 708-12
LID - 10.1007/s00535-009-0070-6 [doi]
AB  - BACKGROUND: Combined multi-channel intra-luminal impedance and pH (Mll-pH) 
      monitoring can detect gastro-esophageal reflux and identify acid and non-acid 
      reflux (NAR) events. It can be used for patients with persistent symptoms who are 
      having proton pump inhibitor (PPI) therapy. The aim of this study is to determine 
      the frequency of acid reflux and NAR and to establish their relationship with 
      persistent reflux symptoms in Japanese patients with non-erosive reflux disease 
      (NERD) who are on a double-dose of PPI therapy. METHODS: Thirteen patients with 
      NERD, with persistent reflux symptoms, despite taking PPI at least twice daily, 
      were included in this study. Twenty-four-hour combined Mll-pH monitoring was 
      carried out on all patients and reflux episodes were detected by impedance 
      channels, located at 3, 5, 7, 9, 15 and 17 cm above the lower esophageal 
      sphincter (LES) and classified into acid reflux and NAR, based on pH data from 5 
      cm above the LES. A positive symptom index (SI) was declared, if at least half of 
      the symptoms were preceded by reflux episodes within 5 min. RESULTS: A total of 
      916 liquid reflux episodes were detected, and a total of 171 symptoms were 
      recorded. Eight (4.7%) of 171 symptoms were related to acid reflux, and 68 
      (39.8%) were related to NAR. Seven (53.8%) patients had a positive SI and in 
      these seven patients, a total of 79 symptoms were recorded. 5 (6.3%) of the 79 
      symptoms were related to acid reflux and 44 (55.7%) were related to NAR. 
      CONCLUSIONS: Persistent reflux symptoms, in SI-positive patients with NERD on 
      double-dose PPI therapy, are more likely to be associated with primarily non-acid 
      reflux.
FAU - Iwakiri, Katsuhiko
AU  - Iwakiri K
AD  - Department of Medicine, Division of Gastroenterology, Nippon Medical School, 
      Sendagi 1-1-5, Bunkyo-ku, Tokyo, 113-8603, Japan. k-iwa@nms.ac.jp
FAU - Kawami, Noriyuki
AU  - Kawami N
FAU - Sano, Hirohito
AU  - Sano H
FAU - Tanaka, Yuriko
AU  - Tanaka Y
FAU - Umezawa, Mariko
AU  - Umezawa M
FAU - Kotoyori, Makoto
AU  - Kotoyori M
FAU - Hoshihara, Yoshio
AU  - Hoshihara Y
FAU - Sakamoto, Choitsu
AU  - Sakamoto C
LA  - eng
PT  - Journal Article
DEP - 20090512
PL  - Japan
TA  - J Gastroenterol
JT  - Journal of gastroenterology
JID - 9430794
RN  - 0 (Proton Pump Inhibitors)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Asian People
MH  - Electric Impedance
MH  - Esophageal pH Monitoring
MH  - Female
MH  - Gastroesophageal Reflux/diagnosis/*drug therapy
MH  - Heartburn/diagnosis
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Proton Pump Inhibitors/*administration & dosage
EDAT- 2009/05/13 09:00
MHDA- 2009/08/25 09:00
CRDT- 2009/05/13 09:00
PHST- 2008/10/05 00:00 [received]
PHST- 2009/03/19 00:00 [accepted]
PHST- 2009/05/13 09:00 [entrez]
PHST- 2009/05/13 09:00 [pubmed]
PHST- 2009/08/25 09:00 [medline]
AID - 10.1007/s00535-009-0070-6 [doi]
PST - ppublish
SO  - J Gastroenterol. 2009;44(7):708-12. doi: 10.1007/s00535-009-0070-6. Epub 2009 May 
      12.