Document Detail


Relationship between symptom response and esophageal pH level on standard dose of esomeprazole treatment for gastroesophageal reflux disease.
MedLine Citation:
PMID:  20819534     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The relationship between symptom elimination and normalization of esophageal acid level of gastroesophageal reflux disease (GERD) on proton-pump inhibitor (PPI) therapy has been questioned. This study aimed to evaluate the relationship between symptom response and gastro-esophageal acidity control in Chinese patients with GERD on esomeprazole therapy, and to assess the role of 24-hour esophageal pH-metry after therapy in GERD patients.
METHODS: GERD patients with typical reflux symptoms were enrolled and received esomeprazole 40 mg once daily for 4 weeks. Patients with positive baseline 24-hour esophageal pH-metry were divided into two groups depending on an additional dual-channel 24-hour pH-metry after treatment. The pH- group achieved normalization of esophageal pH level whereas the pH+ group did not.
RESULTS: Of the 80 patients studied, 76 had abnormal baseline esophageal pH levels. Of these, 90% (52/58) of symptom-free patients and 67% (12/18) of symptom-persistent patients achieved esophageal pH normalization after therapy (P = 0.030). The mean post-therapy gastric nocturnal percent time of pH < 4.0 was significantly higher in pH+ group than that in pH- group (P < 0.001) after therapy. The multivariate regression analysis identified hiatus hernia (P < 0.001) and persistent reflux symptom (P = 0.004) were two independent factors predicting the low post-therapy esophageal pH level.
CONCLUSIONS: Symptom elimination is not always accompanied by esophageal pH normalization, and vice verse. Esophageal pH-metry is recommended for GERD patients with hiatus hernia or with persistent reflux symptoms after PPI therapy.
Authors:
Sui Peng; Li-shou Xiong; Ying-lian Xiao; An-jiang Wang; Jin-kun Lin; Pin-jin Hu; Min-hu Chen
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Chinese medical journal     Volume:  123     ISSN:  0366-6999     ISO Abbreviation:  Chin. Med. J.     Publication Date:  2010 Aug 
Date Detail:
Created Date:  2010-09-07     Completed Date:  2011-02-03     Revised Date:  2013-01-07    
Medline Journal Info:
Nlm Unique ID:  7513795     Medline TA:  Chin Med J (Engl)     Country:  China    
Other Details:
Languages:  eng     Pagination:  2012-7     Citation Subset:  IM    
Affiliation:
Division of Gastroenterology & Hepatology, the First Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong 510080, China.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Anti-Ulcer Agents / therapeutic use
Endoscopy, Gastrointestinal
Esomeprazole Sodium / therapeutic use*
Esophageal pH Monitoring
Esophagus / metabolism,  pathology
Female
Gastroesophageal Reflux / drug therapy*
Humans
Hydrogen-Ion Concentration
Male
Middle Aged
Prospective Studies
Young Adult
Chemical
Reg. No./Substance:
0/Anti-Ulcer Agents; L2C9GWQ43H/Esomeprazole Sodium

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