PMID- 32737802
OWN - NLM
STAT- MEDLINE
DCOM- 20220325
LR  - 20220325
IS  - 1612-9067 (Electronic)
IS  - 1612-9059 (Linking)
VI  - 18
IP  - 2
DP  - 2021 Apr
TI  - Association of residual gastric acid secretion with persistent symptoms in 
      gastroesophageal reflux disease patients receiving standard-dose proton pump 
      inhibitor therapy.
PG  - 380-387
LID - 10.1007/s10388-020-00765-2 [doi]
AB  - BACKGROUND: Although a third of gastroesophageal reflux disease (GERD) patients 
      are refractory to proton pump inhibitor (PPI) therapy, the underlying mechanism 
      of the refractoriness remains unclear. We compared the level of gastric acid 
      suppression during PPI treatment between responders and non-responders by 
      directly measuring gastric acid secretion in GERD patients taking PPIs. METHODS: 
      Seventy-five consecutive patients receiving standard-dose PPI therapy for GERD 
      were prospectively recruited, irrespective of persistent GERD symptoms. They were 
      asked about their GERD symptoms using a validated questionnaire, and 
      simultaneously underwent both a routine endoscopic examination and a gastric acid 
      secretory testing using an endoscopic gastrin test. Associations between residual 
      gastric acid secretion during PPI treatment and persistent GERD symptoms were 
      analyzed by a logistic regression analysis. RESULTS: Overall, 26 of 75 (34.7%) 
      patients were judged to be positive for persistent GERD symptoms. The patients 
      with and without persistent symptoms showed similar gastric acid secretion levels 
      (1.3 [1.3] mEq/10 min vs. 1.4 [2.0] mEq/10 min). Sufficient gastric acid 
      suppression, defined as < 0.6, was not significantly associated with persistent 
      GERD symptoms (odds ratio 1.1, 95% confidence interval 0.40-3.5). CONCLUSIONS: 
      This study provided solid evidence to support that the gastric acid suppression 
      level during PPI treatment does not differ between patients with and without 
      persistent GERD symptoms. The insignificant role of residual gastric acid in the 
      persistent GERD symptoms suggests that the use of medications other than those 
      that enhance gastric acid inhibitory effects would be an essential approach for 
      the management of PPI-refractory GERD.
FAU - Kikuchi, H
AU  - Kikuchi H
AD  - Division of Gastroenterology, Tohoku University Graduate School of Medicine, 1-1 
      Seiryo-machi, Sendai, 980-8574, Japan.
FAU - Fukuda, S
AU  - Fukuda S
AD  - Department of Gastroenterology, Akita University Graduate School of Medicine, 
      1-1-1 Hondo, Akita, Akita, 010-8543, Japan.
FAU - Koike, T
AU  - Koike T
AD  - Division of Gastroenterology, Tohoku University Graduate School of Medicine, 1-1 
      Seiryo-machi, Sendai, 980-8574, Japan.
FAU - Shimodaira, Y
AU  - Shimodaira Y
AD  - Department of Gastroenterology, Akita University Graduate School of Medicine, 
      1-1-1 Hondo, Akita, Akita, 010-8543, Japan.
FAU - Watanabe, K
AU  - Watanabe K
AD  - Department of Gastroenterology, Akita University Graduate School of Medicine, 
      1-1-1 Hondo, Akita, Akita, 010-8543, Japan.
FAU - Saito, M
AU  - Saito M
AD  - Division of Gastroenterology, Tohoku University Graduate School of Medicine, 1-1 
      Seiryo-machi, Sendai, 980-8574, Japan.
FAU - Nakagawa, K
AU  - Nakagawa K
AD  - Division of Gastroenterology, Tohoku University Graduate School of Medicine, 1-1 
      Seiryo-machi, Sendai, 980-8574, Japan.
FAU - Hatta, W
AU  - Hatta W
AD  - Division of Gastroenterology, Tohoku University Graduate School of Medicine, 1-1 
      Seiryo-machi, Sendai, 980-8574, Japan.
FAU - Masamune, A
AU  - Masamune A
AD  - Division of Gastroenterology, Tohoku University Graduate School of Medicine, 1-1 
      Seiryo-machi, Sendai, 980-8574, Japan.
FAU - Iijima, K
AU  - Iijima K
AD  - Department of Gastroenterology, Akita University Graduate School of Medicine, 
      1-1-1 Hondo, Akita, Akita, 010-8543, Japan. kiijima@med.akita-u.ac.jp.
LA  - eng
PT  - Journal Article
DEP - 20200731
PL  - Japan
TA  - Esophagus
JT  - Esophagus : official journal of the Japan Esophageal Society
JID - 101206627
RN  - 0 (Proton Pump Inhibitors)
SB  - IM
MH  - Disease Progression
MH  - Gastric Acid
MH  - *Gastroesophageal Reflux/diagnosis
MH  - Humans
MH  - *Proton Pump Inhibitors/therapeutic use
OTO - NOTNLM
OT  - Gastric acid secretion
OT  - Gastroesophageal reflux diseases
OT  - Proton pump inhibitors
EDAT- 2020/08/02 06:00
MHDA- 2022/03/26 06:00
CRDT- 2020/08/02 06:00
PHST- 2020/04/25 00:00 [received]
PHST- 2020/07/24 00:00 [accepted]
PHST- 2020/08/02 06:00 [pubmed]
PHST- 2022/03/26 06:00 [medline]
PHST- 2020/08/02 06:00 [entrez]
AID - 10.1007/s10388-020-00765-2 [pii]
AID - 10.1007/s10388-020-00765-2 [doi]
PST - ppublish
SO  - Esophagus. 2021 Apr;18(2):380-387. doi: 10.1007/s10388-020-00765-2. Epub 2020 Jul 
      31.