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Clinical trial: persistent gastro-oesophageal reflux symptoms despite standard therapy with proton pump inhibitors - a follow-up study of intraluminal-impedance guided therapy.
Aliment Pharmacol Ther. 2007 Nov 15; 26(10):1355-60.AP

Abstract

BACKGROUND

Persistent gastro-oesophageal reflux disease (GERD), despite proton pump inhibitor (PPI) therapy, is a common problem. Combined pH/impedance monitoring (pH/MII) enables detection of reflux episodes. Aim To identify patients with objective episodes of persistent reflux and second, to evaluate the effect of modified therapy based on the results of pH/MII.

METHODS

In all, 143 patients were examined with pH/MII because of GERD-symptoms resistant to PPI-therapy. Patients with pathological pH/MII (group 1) and with normal results (group 2) were identified. Therapy modifications were evaluated after a minimum follow-up of 3 months.

RESULTS

In 56 of 143 (39.1%) patients, pathological findings in pH/MII were identified. Therapy was escalated in 33/52 patients (group 1) and in 30/71 patients (group 2). Escalating therapy led to symptomatic relief in 90.9% of the patients in group 1 and 43.3% of the patients in group 2 (P < 0.001).

CONCLUSIONS

GERD symptoms refractory to PPI-therapy could be objectively identified with pH/MII in almost 40% of all patients. Furthermore, escalating anti-reflux therapy if pH/MII was pathological is associated with a significantly higher rate of successful treatment compared to the patients with normal findings. Therefore, pH/MII facilitates a more focussed therapeutical approach to patients with PPI-resistant GERD.

Authors+Show Affiliations

II. Medical Department Internal Medicine, Klinikum Rechts der Isar, Technical University of Munich, Germany. valentin.becker@lrz.tum.deNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Journal Article

Language

eng

PubMed ID

17900268

Citation

Becker, V, et al. "Clinical Trial: Persistent Gastro-oesophageal Reflux Symptoms Despite Standard Therapy With Proton Pump Inhibitors - a Follow-up Study of Intraluminal-impedance Guided Therapy." Alimentary Pharmacology & Therapeutics, vol. 26, no. 10, 2007, pp. 1355-60.
Becker V, Bajbouj M, Waller K, et al. Clinical trial: persistent gastro-oesophageal reflux symptoms despite standard therapy with proton pump inhibitors - a follow-up study of intraluminal-impedance guided therapy. Aliment Pharmacol Ther. 2007;26(10):1355-60.
Becker, V., Bajbouj, M., Waller, K., Schmid, R. M., & Meining, A. (2007). Clinical trial: persistent gastro-oesophageal reflux symptoms despite standard therapy with proton pump inhibitors - a follow-up study of intraluminal-impedance guided therapy. Alimentary Pharmacology & Therapeutics, 26(10), 1355-60.
Becker V, et al. Clinical Trial: Persistent Gastro-oesophageal Reflux Symptoms Despite Standard Therapy With Proton Pump Inhibitors - a Follow-up Study of Intraluminal-impedance Guided Therapy. Aliment Pharmacol Ther. 2007 Nov 15;26(10):1355-60. PubMed PMID: 17900268.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Clinical trial: persistent gastro-oesophageal reflux symptoms despite standard therapy with proton pump inhibitors - a follow-up study of intraluminal-impedance guided therapy. AU - Becker,V, AU - Bajbouj,M, AU - Waller,K, AU - Schmid,R M, AU - Meining,A, Y1 - 2007/09/26/ PY - 2007/9/29/pubmed PY - 2008/4/1/medline PY - 2007/9/29/entrez SP - 1355 EP - 60 JF - Alimentary pharmacology & therapeutics JO - Aliment Pharmacol Ther VL - 26 IS - 10 N2 - BACKGROUND: Persistent gastro-oesophageal reflux disease (GERD), despite proton pump inhibitor (PPI) therapy, is a common problem. Combined pH/impedance monitoring (pH/MII) enables detection of reflux episodes. Aim To identify patients with objective episodes of persistent reflux and second, to evaluate the effect of modified therapy based on the results of pH/MII. METHODS: In all, 143 patients were examined with pH/MII because of GERD-symptoms resistant to PPI-therapy. Patients with pathological pH/MII (group 1) and with normal results (group 2) were identified. Therapy modifications were evaluated after a minimum follow-up of 3 months. RESULTS: In 56 of 143 (39.1%) patients, pathological findings in pH/MII were identified. Therapy was escalated in 33/52 patients (group 1) and in 30/71 patients (group 2). Escalating therapy led to symptomatic relief in 90.9% of the patients in group 1 and 43.3% of the patients in group 2 (P < 0.001). CONCLUSIONS: GERD symptoms refractory to PPI-therapy could be objectively identified with pH/MII in almost 40% of all patients. Furthermore, escalating anti-reflux therapy if pH/MII was pathological is associated with a significantly higher rate of successful treatment compared to the patients with normal findings. Therefore, pH/MII facilitates a more focussed therapeutical approach to patients with PPI-resistant GERD. SN - 0269-2813 UR - https://www.unboundmedicine.com/medline/citation/17900268/Clinical_trial:_persistent_gastro_oesophageal_reflux_symptoms_despite_standard_therapy_with_proton_pump_inhibitors___a_follow_up_study_of_intraluminal_impedance_guided_therapy_ L2 - https://doi.org/10.1111/j.1365-2036.2007.03529.x DB - PRIME DP - Unbound Medicine ER -