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Relationship between symptom response and esophageal pH level on standard dose of esomeprazole treatment for gastroesophageal reflux disease.
Chin Med J (Engl) 2010; 123(15):2012-7CM

Abstract

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+Show Affiliations

Division of Gastroenterology & Hepatology, the First Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong 510080, China.No 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

20819534

Citation

Peng, Sui, et al. "Relationship Between Symptom Response and Esophageal pH Level On Standard Dose of Esomeprazole Treatment for Gastroesophageal Reflux Disease." Chinese Medical Journal, vol. 123, no. 15, 2010, pp. 2012-7.
Peng S, Xiong LS, Xiao YL, et al. Relationship between symptom response and esophageal pH level on standard dose of esomeprazole treatment for gastroesophageal reflux disease. Chin Med J. 2010;123(15):2012-7.
Peng, S., Xiong, L. S., Xiao, Y. L., Wang, A. J., Lin, J. K., Hu, P. J., & Chen, M. H. (2010). Relationship between symptom response and esophageal pH level on standard dose of esomeprazole treatment for gastroesophageal reflux disease. Chinese Medical Journal, 123(15), pp. 2012-7.
Peng S, et al. Relationship Between Symptom Response and Esophageal pH Level On Standard Dose of Esomeprazole Treatment for Gastroesophageal Reflux Disease. Chin Med J. 2010 Aug 5;123(15):2012-7. PubMed PMID: 20819534.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Relationship between symptom response and esophageal pH level on standard dose of esomeprazole treatment for gastroesophageal reflux disease. AU - Peng,Sui, AU - Xiong,Li-shou, AU - Xiao,Ying-lian, AU - Wang,An-jiang, AU - Lin,Jin-kun, AU - Hu,Pin-jin, AU - Chen,Min-hu, PY - 2010/9/8/entrez PY - 2010/9/8/pubmed PY - 2011/2/4/medline SP - 2012 EP - 7 JF - Chinese medical journal JO - Chin. Med. J. VL - 123 IS - 15 N2 - 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. SN - 0366-6999 UR - https://www.unboundmedicine.com/medline/citation/20819534/Relationship_between_symptom_response_and_esophageal_pH_level_on_standard_dose_of_esomeprazole_treatment_for_gastroesophageal_reflux_disease_ L2 - http://Insights.ovid.com/pubmed?pmid=20819534 DB - PRIME DP - Unbound Medicine ER -