PMID- 23128301
OWN - NLM
STAT- MEDLINE
DCOM- 20130710
LR  - 20181202
IS  - 1421-9867 (Electronic)
IS  - 0012-2823 (Linking)
VI  - 86
IP  - 4
DP  - 2012
TI  - Prospective evaluation of duodenogastroesophageal reflux in gastroesophageal 
      reflux disease patients refractory to proton pump inhibitor therapy.
PG  - 315-22
LID - 10.1159/000342234 [doi]
AB  - 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.
CI  - Copyright (c) 2012 S. Karger AG, Basel.
FAU - Kunsch, S
AU  - Kunsch S
AD  - Department of Gastroenterology, Endocrinology and Metabolism, Faculty of 
      Medicine, Philipps University of Marburg, Marburg, Germany.
FAU - Neesse, A
AU  - Neesse A
FAU - Linhart, T
AU  - Linhart T
FAU - Nell, C
AU  - Nell C
FAU - Gress, T M
AU  - Gress TM
FAU - Ellenrieder, V
AU  - Ellenrieder V
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20121101
PL  - Switzerland
TA  - Digestion
JT  - Digestion
JID - 0150472
RN  - 0 (2-Pyridinylmethylsulfinylbenzimidazoles)
RN  - 0 (Proton Pump Inhibitors)
RN  - D8TST4O562 (Pantoprazole)
SB  - IM
MH  - 2-Pyridinylmethylsulfinylbenzimidazoles/*therapeutic use
MH  - Adult
MH  - Bile Reflux/*complications/diagnosis/drug therapy
MH  - Drug Resistance
MH  - Esophageal Sphincter, Lower/physiopathology
MH  - Esophageal pH Monitoring
MH  - Esophagoscopy
MH  - Female
MH  - Gastroesophageal Reflux/*complications/*drug therapy
MH  - Humans
MH  - Male
MH  - Manometry
MH  - Middle Aged
MH  - Pantoprazole
MH  - Prospective Studies
MH  - Proton Pump Inhibitors/*therapeutic use
MH  - Statistics, Nonparametric
EDAT- 2012/11/07 06:00
MHDA- 2013/07/11 06:00
CRDT- 2012/11/07 06:00
PHST- 2012/02/24 00:00 [received]
PHST- 2012/07/30 00:00 [accepted]
PHST- 2012/11/07 06:00 [entrez]
PHST- 2012/11/07 06:00 [pubmed]
PHST- 2013/07/11 06:00 [medline]
AID - 000342234 [pii]
AID - 10.1159/000342234 [doi]
PST - ppublish
SO  - Digestion. 2012;86(4):315-22. doi: 10.1159/000342234. Epub 2012 Nov 1.