PMID- 21625270
OWN - NLM
STAT- MEDLINE
DCOM- 20130211
LR  - 20221207
IS  - 1572-0241 (Electronic)
IS  - 0002-9270 (Linking)
VI  - 107
IP  - 11
DP  - 2012 Nov
TI  - Selective serotonin reuptake inhibitors for the treatment of hypersensitive 
      esophagus: a randomized, double-blind, placebo-controlled study.
PG  - 1662-7
LID - 10.1038/ajg.2011.179 [doi]
AB  - OBJECTIVES: Ambulatory 24-h pH-impedance monitoring can be used to assess the 
      relationship of persistent symptoms and reflux episodes, despite proton pump 
      inhibitor (PPI) therapy. Using this technique, we aimed to identify patients with 
      hypersensitive esophagus and evaluate the effect of selective serotonin reuptake 
      inhibitors (SSRIs) on their symptoms. METHODS: Patients with normal endoscopy and 
      typical reflux symptoms (heartburn, chest pain, and regurgitation), despite PPI 
      therapy twice daily, underwent 24-h pH-impedance monitoring. Distal esophageal 
      acid exposure (% time pH <4) was measured and reflux episodes were classified 
      into acid or non-acid. A positive symptom index (SI) was declared if at least 
      half of the symptom events were preceded by reflux episodes. Patients with a 
      normal distal esophageal acid exposure time, but with a positive SI were 
      classified as having hypersensitive esophagus and were randomized to receive 
      citalopram 20 mg or placebo once daily for 6 months. RESULTS: A total of 252 
      patients (150 females (59.5%); mean age 55 (range 18-75) years) underwent 24-h 
      pH-impedance monitoring. Two hundred and nineteen patients (86.9%) recorded 
      symptoms during the study day, while 105 (47.9%) of those had a positive SI (22 
      (20.95%) with acid, 5 (4.76%) with both acid and non-acid, and 78 (74.29%) with 
      non-acid reflux). Among those 105 patients, 75 (71.4%) had normal distal 
      esophageal acid exposure time and were randomized to receive citalopram 20 mg 
      (group A, n=39) or placebo (group B, n=36). At the end of the follow-up period, 
      15 out of the 39 patients of group A (38.5%) and 24 out of the 36 patients of 
      group B (66.7%) continue to report reflux symptoms (P=0.021). CONCLUSIONS: 
      Treatment with SSRIs is effective in a select group of patients with 
      hypersensitive esophagus.
FAU - Viazis, Nikos
AU  - Viazis N
AD  - 2nd Department of Gastroenterology, Evangelismos Hospital, Athens, Greece. 
      nikos.viazis@gmail.com
FAU - Keyoglou, Anastasia
AU  - Keyoglou A
FAU - Kanellopoulos, Alexandros K
AU  - Kanellopoulos AK
FAU - Karamanolis, George
AU  - Karamanolis G
FAU - Vlachogiannakos, John
AU  - Vlachogiannakos J
FAU - Triantafyllou, Konstantinos
AU  - Triantafyllou K
FAU - Ladas, Spiros D
AU  - Ladas SD
FAU - Karamanolis, Dimitrios G
AU  - Karamanolis DG
LA  - eng
PT  - Journal Article
PT  - Randomized Controlled Trial
DEP - 20110531
PL  - United States
TA  - Am J Gastroenterol
JT  - The American journal of gastroenterology
JID - 0421030
RN  - 0 (Placebos)
RN  - 0 (Proton Pump Inhibitors)
RN  - 0 (Serotonin Uptake Inhibitors)
RN  - 0DHU5B8D6V (Citalopram)
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Aged
MH  - Citalopram/*therapeutic use
MH  - Double-Blind Method
MH  - Esophageal pH Monitoring
MH  - Female
MH  - Gastroesophageal Reflux/diagnosis/*drug therapy/physiopathology
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Placebos
MH  - Proton Pump Inhibitors/therapeutic use
MH  - Selective Serotonin Reuptake Inhibitors/*therapeutic use
MH  - Treatment Outcome
EDAT- 2011/06/01 06:00
MHDA- 2013/02/12 06:00
CRDT- 2011/06/01 06:00
PHST- 2011/06/01 06:00 [entrez]
PHST- 2011/06/01 06:00 [pubmed]
PHST- 2013/02/12 06:00 [medline]
AID - ajg2011179 [pii]
AID - 10.1038/ajg.2011.179 [doi]
PST - ppublish
SO  - Am J Gastroenterol. 2012 Nov;107(11):1662-7. doi: 10.1038/ajg.2011.179. Epub 2011 
      May 31.