PMID- 24744591 OWN - NLM STAT- MEDLINE DCOM- 20150413 LR - 20211021 IS - 2219-2840 (Electronic) IS - 1007-9327 (Print) IS - 1007-9327 (Linking) VI - 20 IP - 14 DP - 2014 Apr 14 TI - Positive predictors for gastroesophageal reflux disease and the therapeutic response to proton-pump inhibitors. PG - 4017-24 LID - 10.3748/wjg.v20.i14.4017 [doi] AB - AIM: To identify objective and subjective predictors for the reliable diagnosis of gastroesophageal reflux disease (GERD) and the response to proton pump inhibitor (PPI) therapy. METHODS: Retrospectively, 683 consecutive patients suspected for GERD who underwent pH-metry/impedance measurement (pH/MII) were analyzed. All patients had previously undergone standard PPI treatment (e.g., pantoprazole 40 mg/d or comparable). Four hundred sixty patients were at least 10 d off PPIs (group A), whereas 223 patients were analyzed during their ongoing PPI therapy (group B). In addition, all patients completed a standardized symptom- and lifestyle-based questionnaire, including the therapeutic response to previous PPI trials on a 10-point scale. Uni- and multivariance analyses were performed to identify criteria associated with positive therapeutic response to PPIs. RESULTS: In group A, positive predictors (PPs) for response in empirical PPI trials were typical GERD symptoms (heartburn and regurgitation), a positive symptom index (SI) and pathological results in pH/MII, along with atypical symptoms, including hoarseness and fullness. In group B, regular alcohol consumption was associated with the therapeutic response. The PPs for pathological results in pH/MII in group A included positive SI, male gender, obesity, heartburn and regurgitation. In group B, the PPs were positive SI and vomiting. Analyzing for positive SI, the PPs were pathological pH and/or MII, heartburn regurgitation, fullness, nausea and vomiting in group A and pathological pH and/or MII in group B. CONCLUSION: Anamnestic parameters (gender, obesity, alcohol) can predict PPI responses. In non-obese, female patients with non-typical reflux symptoms, pH/MII should be considered instead of empirical PPIs. FAU - Becker, Valentin AU - Becker V AD - Valentin Becker, Stefan Grotz, Christoph Schlag, Simon Nennstiel, Analena Beitz, Roland M Schmid, Alexander Meining, Monther Bajbouj, II. Medizinische Klinik und Poliklinik, Technische Universitat Munchen, D-81675 Munich, Germany. FAU - Grotz, Stefan AU - Grotz S AD - Valentin Becker, Stefan Grotz, Christoph Schlag, Simon Nennstiel, Analena Beitz, Roland M Schmid, Alexander Meining, Monther Bajbouj, II. Medizinische Klinik und Poliklinik, Technische Universitat Munchen, D-81675 Munich, Germany. FAU - Schlag, Christoph AU - Schlag C AD - Valentin Becker, Stefan Grotz, Christoph Schlag, Simon Nennstiel, Analena Beitz, Roland M Schmid, Alexander Meining, Monther Bajbouj, II. Medizinische Klinik und Poliklinik, Technische Universitat Munchen, D-81675 Munich, Germany. FAU - Nennstiel, Simon AU - Nennstiel S AD - Valentin Becker, Stefan Grotz, Christoph Schlag, Simon Nennstiel, Analena Beitz, Roland M Schmid, Alexander Meining, Monther Bajbouj, II. Medizinische Klinik und Poliklinik, Technische Universitat Munchen, D-81675 Munich, Germany. FAU - Beitz, Analena AU - Beitz A AD - Valentin Becker, Stefan Grotz, Christoph Schlag, Simon Nennstiel, Analena Beitz, Roland M Schmid, Alexander Meining, Monther Bajbouj, II. Medizinische Klinik und Poliklinik, Technische Universitat Munchen, D-81675 Munich, Germany. FAU - Haller, Bernhard AU - Haller B AD - Valentin Becker, Stefan Grotz, Christoph Schlag, Simon Nennstiel, Analena Beitz, Roland M Schmid, Alexander Meining, Monther Bajbouj, II. Medizinische Klinik und Poliklinik, Technische Universitat Munchen, D-81675 Munich, Germany. FAU - Schmid, Roland M AU - Schmid RM AD - Valentin Becker, Stefan Grotz, Christoph Schlag, Simon Nennstiel, Analena Beitz, Roland M Schmid, Alexander Meining, Monther Bajbouj, II. Medizinische Klinik und Poliklinik, Technische Universitat Munchen, D-81675 Munich, Germany. FAU - Meining, Alexander AU - Meining A AD - Valentin Becker, Stefan Grotz, Christoph Schlag, Simon Nennstiel, Analena Beitz, Roland M Schmid, Alexander Meining, Monther Bajbouj, II. Medizinische Klinik und Poliklinik, Technische Universitat Munchen, D-81675 Munich, Germany. FAU - Bajbouj, Monther AU - Bajbouj M AD - Valentin Becker, Stefan Grotz, Christoph Schlag, Simon Nennstiel, Analena Beitz, Roland M Schmid, Alexander Meining, Monther Bajbouj, II. Medizinische Klinik und Poliklinik, Technische Universitat Munchen, D-81675 Munich, Germany. LA - eng PT - Journal Article PL - United States TA - World J Gastroenterol JT - World journal of gastroenterology JID - 100883448 RN - 0 (2-Pyridinylmethylsulfinylbenzimidazoles) RN - 0 (Proton Pump Inhibitors) RN - D8TST4O562 (Pantoprazole) SB - IM MH - 2-Pyridinylmethylsulfinylbenzimidazoles/therapeutic use MH - Adult MH - Aged MH - Electric Impedance MH - Esophageal pH Monitoring MH - Female MH - Gastroesophageal Reflux/*diagnosis/*drug therapy MH - Heartburn MH - Humans MH - Hydrogen-Ion Concentration MH - Life Style MH - Male MH - Middle Aged MH - Multivariate Analysis MH - Pantoprazole MH - Predictive Value of Tests MH - Proton Pump Inhibitors/*therapeutic use MH - ROC Curve MH - Retrospective Studies MH - Surveys and Questionnaires MH - Treatment Outcome PMC - PMC3983457 OTO - NOTNLM OT - Follow-up OT - Gastroesophageal reflux OT - Gastroesophageal reflux disease OT - Impedance pH measurement OT - Non-erosive reflux disease OT - Proton pump inhibitor OT - Therapy EDAT- 2014/04/20 06:00 MHDA- 2015/04/14 06:00 PMCR- 2014/04/14 CRDT- 2014/04/19 06:00 PHST- 2013/10/07 00:00 [received] PHST- 2013/12/20 00:00 [revised] PHST- 2014/01/08 00:00 [accepted] PHST- 2014/04/19 06:00 [entrez] PHST- 2014/04/20 06:00 [pubmed] PHST- 2015/04/14 06:00 [medline] PHST- 2014/04/14 00:00 [pmc-release] AID - 10.3748/wjg.v20.i14.4017 [doi] PST - ppublish SO - World J Gastroenterol. 2014 Apr 14;20(14):4017-24. doi: 10.3748/wjg.v20.i14.4017.