PMID- 24326754
OWN - NLM
STAT- MEDLINE
DCOM- 20150330
LR  - 20140704
IS  - 1539-2031 (Electronic)
IS  - 0192-0790 (Linking)
VI  - 48
IP  - 7
DP  - 2014 Aug
TI  - pH-Impedance Findings and proton pump inhibitors-responsiveness in patients with 
      typical gastroesophageal reflux disease symptoms in a large single-center Italian 
      series.
PG  - 613-9
LID - 10.1097/MCG.0000000000000051 [doi]
AB  - INTRODUCTION: A multicenter study with a limited sample size found that absence 
      of esophagitis, presence of functional digestive disorders, and overweight were 
      associated with proton pump inhibitors (PPI) failure. AIM: To assess clinical and 
      reflux patterns associated with PPI-responsiveness. MATERIALS AND METHODS: 
      Patients with typical gastroesophageal reflux disease (GORD) symptoms had 24 
      hours pH-impedance monitoring off therapy. Responders had <2 days of symptoms per 
      week while on standard-dose/double-dose PPI. Clinical and reflux parameters were 
      considered for analysis. RESULTS: A total of 514 patients were included (267 
      women), 185 patients were considered PPI responders, and 329 were considered 
      nonresponders. In the whole population, the only significant factor in the 
      prediction of responsiveness to PPI at the multivariate analysis was the presence 
      of esophagitis (P=0.028). The factors identified as significant in patients with 
      a pathologic acid exposure (142 patients) in the prediction of responsiveness to 
      PPI were overweight (body mass index >25 kg/m(2)) and the presence of esophagitis 
      (P=0.019 and 0.043, respectively). CONCLUSIONS: We confirm that no reflux pattern 
      demonstrated by 24 hours pH-impedance monitoring is associated to PPI response in 
      GORD patients. Presence of esophagitis in the whole population and overweight in 
      patients with pathologic GORD, but not dyspepsia, are strongly associated with 
      PPI-responsiveness.
FAU - Vailati, Cristian
AU  - Vailati C
AD  - Division of Gastroenterology and Gastrointestinal Endoscopy, Vita-Salute San 
      Raffaele University, San Raffaele Scientific Institute, Milan, Italy.
FAU - Mazzoleni, Giorgia
AU  - Mazzoleni G
FAU - Testoni, Pier Alberto
AU  - Testoni PA
FAU - Passaretti, Sandro
AU  - Passaretti S
LA  - eng
PT  - Journal Article
PT  - Multicenter Study
PL  - United States
TA  - J Clin Gastroenterol
JT  - Journal of clinical gastroenterology
JID - 7910017
RN  - 0 (Proton Pump Inhibitors)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Body Mass Index
MH  - Electric Impedance
MH  - Esophageal pH Monitoring
MH  - Esophagitis/complications/physiopathology
MH  - Female
MH  - Gastroesophageal Reflux/complications/*drug therapy/*physiopathology
MH  - Heartburn/complications/physiopathology
MH  - Humans
MH  - Male
MH  - Manometry
MH  - Middle Aged
MH  - Overweight/complications/physiopathology
MH  - Proton Pump Inhibitors/*therapeutic use
MH  - Treatment Failure
EDAT- 2013/12/12 06:00
MHDA- 2015/03/31 06:00
CRDT- 2013/12/12 06:00
PHST- 2013/12/12 06:00 [entrez]
PHST- 2013/12/12 06:00 [pubmed]
PHST- 2015/03/31 06:00 [medline]
AID - 10.1097/MCG.0000000000000051 [doi]
PST - ppublish
SO  - J Clin Gastroenterol. 2014 Aug;48(7):613-9. doi: 10.1097/MCG.0000000000000051.