PMID- 35648971
OWN - NLM
STAT- MEDLINE
DCOM- 20230410
LR  - 20230603
IS  - 1539-2031 (Electronic)
IS  - 0192-0790 (Linking)
VI  - 57
IP  - 5
DP  - 2023 May-Jun 01
TI  - Relevance of Excessive Air Swallowing in GERD Patients With Concomitant 
      Functional Dyspepsia and Poor Response to PPI Therapy.
PG  - 466-471
LID - 10.1097/MCG.0000000000001728 [doi]
AB  - GOALS: The present study was aimed at evaluating the possible role of air 
      swallowing in the association between gastroesophageal reflux disease (GERD) 
      symptoms and concomitant functional dyspepsia (FD) and their role in GERD symptom 
      persistence despite proton pump inhibitor (PPI) therapy. BACKGROUND: It has been 
      shown that individuals with excessive air swallowing experience FD. It has been 
      also demonstrated that a consistent group of GERD patients not responding to PPI 
      therapy swallow more air during mealtime and also have more mixed refluxes. 
      MATERIALS AND METHODS: Multichannel intraluminal impedance-pH tracings from 
      consecutive patients were retrospectively evaluated. A validated structured 
      questionnaire was used to evaluate GERD and concomitant FD symptoms. All patients 
      were treated, within the previous year, with at least 8 weeks of standard-dose 
      PPI therapy. RESULTS: A total of 35 patients with conclusive GERD, 35 patients 
      with reflux hypersensitivity, and 35 with functional heartburn were studied. A 
      direct relationship was observed between the number of air swallows and of mixed 
      refluxes ( R =0.64). At receiver operating characteristic curve analysis, air 
      swallows and mixed refluxes were significantly associated to the presence of FD 
      and PPI refractoriness. An air swallow cutoff of 107 episodes/24 hours was 
      identified to discriminate patients with and without FD (sensitivity: 87%, 
      specificity: 82.8%). A mixed reflux cutoff of 34 episodes/24 hours was identified 
      to discriminate PPI responders from nonresponders (sensitivity: 84.8%, 
      specificity: 69%). At multivariate analysis, an abnormal number of air swallows 
      and of mixed refluxes were significantly associated to FD and PPI refractoriness. 
      CONCLUSION: Our study highlights the relevant role of excessive air swallowing in 
      eliciting both dyspepsia and refractoriness of typical GERD symptoms to PPI 
      therapy.
CI  - Copyright (c) 2022 Wolters Kluwer Health, Inc. All rights reserved.
FAU - Ribolsi, Mentore
AU  - Ribolsi M
AD  - Department of Digestive Diseases, Campus Bio-Medico University of Rome, Rome.
FAU - Savarino, Edoardo
AU  - Savarino E
AD  - Gastroenterology Unit, Department of Surgery, Oncology, and Gastroenterology, 
      University of Padua, Padova.
FAU - Frazzoni, Marzio
AU  - Frazzoni M
AD  - Digestive Pathophysiology Unit, Baggiovara Hospital, Modena, Italy.
FAU - Cicala, Michele
AU  - Cicala M
AD  - Department of Digestive Diseases, Campus Bio-Medico University of Rome, Rome.
LA  - eng
PT  - Journal Article
DEP - 20220601
PL  - United States
TA  - J Clin Gastroenterol
JT  - Journal of clinical gastroenterology
JID - 7910017
RN  - 0 (Proton Pump Inhibitors)
SB  - IM
MH  - Humans
MH  - *Dyspepsia/drug therapy
MH  - Retrospective Studies
MH  - Aerophagy/complications/drug therapy
MH  - Proton Pump Inhibitors/therapeutic use
MH  - *Gastroesophageal Reflux/complications/drug therapy/diagnosis
MH  - Esophageal pH Monitoring
EDAT- 2022/06/02 06:00
MHDA- 2023/04/10 06:42
CRDT- 2022/06/01 14:23
PHST- 2022/01/10 00:00 [received]
PHST- 2022/05/09 00:00 [accepted]
PHST- 2023/04/10 06:42 [medline]
PHST- 2022/06/02 06:00 [pubmed]
PHST- 2022/06/01 14:23 [entrez]
AID - 00004836-990000000-00031 [pii]
AID - 10.1097/MCG.0000000000001728 [doi]
PST - ppublish
SO  - J Clin Gastroenterol. 2023 May-Jun 01;57(5):466-471. doi: 
      10.1097/MCG.0000000000001728. Epub 2022 Jun 1.