PMID- 28161707
OWN - NLM
STAT- MEDLINE
DCOM- 20170606
LR  - 20181202
IS  - 1421-9867 (Electronic)
IS  - 0012-2823 (Linking)
VI  - 95
IP  - 2
DP  - 2017
TI  - Pathogenesis of Double-Dose Proton Pump Inhibitor-Resistant Non-Erosive Reflux 
      Disease, and Mechanism of Reflux Symptoms and Gastric Acid Secretion-Suppressive 
      Effect in the Presence or Absence of Helicobacter pylori Infection.
PG  - 140-145
LID - 10.1159/000455834 [doi]
AB  - BACKGROUND: Various mechanisms have been suggested to be responsible for 
      contributing to the occurrence of proton pump inhibitor (PPI)-resistant 
      non-erosive reflux disease (NERD). The aims of this study were to clarify the 
      pathogenesis of PPI-resistant NERD. METHODS: Fifty-three patients with NERD, who 
      had persistent reflux symptoms despite taking double-dose PPI, were included in 
      this study. After excluding eosinophilic esophagitis (EoE) and primary esophageal 
      motility disorder, esophageal impedance-pH monitoring was carried out. In symptom 
      index (SI)-positive patients, the mechanism of SI positivity and the percent time 
      with intragastric pH >4 were investigated according to the presence or absence of 
      Helicobacter pylori infection. RESULTS: One of the 53 patients had EoE, and 4 had 
      primary esophageal motility disorder. Twenty-three and 2 patients were 
      SI-positive for liquid and gas-only reflux respectively. Of 17 SI-positive, H. 
      pylori-negative patients, 5 were SI-positive for acid reflux, whereas all of the 
      H. pylori-positive patients were SI-positive for non-acid reflux. The percent 
      time with intragastric pH >4 was significantly lower in the H. pylori-negative 
      patients than in the H. pylori-positive patients. CONCLUSIONS: The pathogenesis 
      of double-dose PPI-resistant NERD was identified in 57%. In some of H. 
      pylori-negative patients, acid-related symptoms were observed. However, in H. 
      pylori-positive patients, these symptoms were excluded by taking double-dose PPI.
CI  - (c) 2017 S. Karger AG, Basel.
FAU - Kawami, Noriyuki
AU  - Kawami N
AD  - Department of Gastroenterology, Nippon Medical School, Graduate School of 
      Medicine, Tokyo, Japan.
FAU - Takenouchi, Nana
AU  - Takenouchi N
FAU - Umezawa, Mariko
AU  - Umezawa M
FAU - Hoshino, Shintaro
AU  - Hoshino S
FAU - Hanada, Yuriko
AU  - Hanada Y
FAU - Hoshikawa, Yoshimasa
AU  - Hoshikawa Y
FAU - Sano, Hirohito
AU  - Sano H
FAU - Hoshihara, Yoshio
AU  - Hoshihara Y
FAU - Nomura, Tsutomu
AU  - Nomura T
FAU - Uchida, Eiji
AU  - Uchida E
FAU - Iwakiri, Katsuhiko
AU  - Iwakiri K
LA  - eng
PT  - Journal Article
DEP - 20170204
PL  - Switzerland
TA  - Digestion
JT  - Digestion
JID - 0150472
RN  - 0 (Proton Pump Inhibitors)
SB  - IM
MH  - *Drug Resistance
MH  - Eosinophilic Esophagitis/diagnosis
MH  - Esophageal Motility Disorders/diagnosis
MH  - Esophageal pH Monitoring
MH  - Female
MH  - Gastric Acid/*metabolism
MH  - Gastroesophageal Reflux/diagnosis/*drug therapy/*etiology
MH  - Helicobacter Infections/*diagnosis/microbiology
MH  - Helicobacter pylori/isolation & purification
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Proton Pump Inhibitors/administration & dosage/*pharmacology
EDAT- 2017/02/06 06:00
MHDA- 2017/06/07 06:00
CRDT- 2017/02/06 06:00
PHST- 2016/10/07 00:00 [received]
PHST- 2017/01/05 00:00 [accepted]
PHST- 2017/02/06 06:00 [pubmed]
PHST- 2017/06/07 06:00 [medline]
PHST- 2017/02/06 06:00 [entrez]
AID - 000455834 [pii]
AID - 10.1159/000455834 [doi]
PST - ppublish
SO  - Digestion. 2017;95(2):140-145. doi: 10.1159/000455834. Epub 2017 Feb 4.