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Water load test before and after PPI therapy in patients with gastro-oesophageal reflux disease.
Dig Liver Dis 2007; 39(12):1052-6DL

Abstract

BACKGROUND

Patients with gastro-oesophageal reflux disease may complain of epigastric pain, bloating, early satiety, epigastric fullness, epigastric burning, nausea and vomiting.

AIMS

To evaluate the symptoms in response to gastric distension and its relationship to a therapeutic course in patients with gastro-oesophageal reflux disease using the water load test, compared to healthy controls.

METHODS

Thirty gastro-oesophageal reflux disease patients with grade A oesophagitis (studied before and after 4 weeks of therapy with esomeprazole, 40 mg per day) and 15 patients with reflux-related symptoms demonstrated at wireless pH monitoring (non-erosive reflux disease) were compared to 30 healthy volunteers.

RESULTS

Patients with grade A oesophagitis and with reflux-related symptoms ingested significantly lower water volumes than did controls, before onset of fullness, without statistically significant difference between erosive or non-erosive gastro-oesophageal reflux disease; this variable improved in patients after treatment. Nausea scores were higher basally in patients, pre- and post-therapy, and improved after therapy. Thirty-minute fullness and bloating scores improved after therapy in all gastro-oesophageal reflux disease patients compared to controls and pre-therapy. In all pre-treatment patients, a significant correlation was found only with epigastric fullness; after treatment, there was no significant relationship between the water load and the symptom scores.

CONCLUSIONS

In patients with reflux-related symptoms, with or without grade A oesophagitis, the water load test is frequently abnormal, suggesting an altered gastric function. This could explain the incomplete resolution of symptoms after treatment in some patients, and should lead to additional studies aimed at exploring gastric function in gastro-oesophageal reflux disease patients.

Authors+Show Affiliations

Gastroenterology and Endoscopy Unit, Cardinal Massaja Hospital, Asti, Italy.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

17913607

Citation

Battaglia, E, et al. "Water Load Test Before and After PPI Therapy in Patients With Gastro-oesophageal Reflux Disease." Digestive and Liver Disease : Official Journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver, vol. 39, no. 12, 2007, pp. 1052-6.
Battaglia E, Grassini M, Navino M, et al. Water load test before and after PPI therapy in patients with gastro-oesophageal reflux disease. Dig Liver Dis. 2007;39(12):1052-6.
Battaglia, E., Grassini, M., Navino, M., Niola, P., Verna, C., Mazzocchi, A., ... Bassotti, G. (2007). Water load test before and after PPI therapy in patients with gastro-oesophageal reflux disease. Digestive and Liver Disease : Official Journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver, 39(12), pp. 1052-6.
Battaglia E, et al. Water Load Test Before and After PPI Therapy in Patients With Gastro-oesophageal Reflux Disease. Dig Liver Dis. 2007;39(12):1052-6. PubMed PMID: 17913607.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Water load test before and after PPI therapy in patients with gastro-oesophageal reflux disease. AU - Battaglia,E, AU - Grassini,M, AU - Navino,M, AU - Niola,P, AU - Verna,C, AU - Mazzocchi,A, AU - Clerici,C, AU - Morelli,A, AU - Bassotti,G, Y1 - 2007/10/29/ PY - 2006/10/28/received PY - 2007/06/08/revised PY - 2007/08/17/accepted PY - 2007/10/5/pubmed PY - 2008/3/12/medline PY - 2007/10/5/entrez SP - 1052 EP - 6 JF - Digestive and liver disease : official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver JO - Dig Liver Dis VL - 39 IS - 12 N2 - BACKGROUND: Patients with gastro-oesophageal reflux disease may complain of epigastric pain, bloating, early satiety, epigastric fullness, epigastric burning, nausea and vomiting. AIMS: To evaluate the symptoms in response to gastric distension and its relationship to a therapeutic course in patients with gastro-oesophageal reflux disease using the water load test, compared to healthy controls. METHODS: Thirty gastro-oesophageal reflux disease patients with grade A oesophagitis (studied before and after 4 weeks of therapy with esomeprazole, 40 mg per day) and 15 patients with reflux-related symptoms demonstrated at wireless pH monitoring (non-erosive reflux disease) were compared to 30 healthy volunteers. RESULTS: Patients with grade A oesophagitis and with reflux-related symptoms ingested significantly lower water volumes than did controls, before onset of fullness, without statistically significant difference between erosive or non-erosive gastro-oesophageal reflux disease; this variable improved in patients after treatment. Nausea scores were higher basally in patients, pre- and post-therapy, and improved after therapy. Thirty-minute fullness and bloating scores improved after therapy in all gastro-oesophageal reflux disease patients compared to controls and pre-therapy. In all pre-treatment patients, a significant correlation was found only with epigastric fullness; after treatment, there was no significant relationship between the water load and the symptom scores. CONCLUSIONS: In patients with reflux-related symptoms, with or without grade A oesophagitis, the water load test is frequently abnormal, suggesting an altered gastric function. This could explain the incomplete resolution of symptoms after treatment in some patients, and should lead to additional studies aimed at exploring gastric function in gastro-oesophageal reflux disease patients. SN - 1590-8658 UR - https://www.unboundmedicine.com/medline/citation/17913607/Water_load_test_before_and_after_PPI_therapy_in_patients_with_gastro_oesophageal_reflux_disease_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1590-8658(07)00523-3 DB - PRIME DP - Unbound Medicine ER -