• Tomohiko Shimatani, Mitsushige Sugimoto, Masafumi Nishino, Kyoichi Adachi, Kenji Furuta, Masanori Ito, Susumu Kurosawa, Noriaki Manabe, Kotaro Mannen, Michio Hongo, Tsutomu Chiba, Yoshikazu Kinoshita, and Acid-Related Symptom Research (ARS) Group.
• Division of Adult Nursing and Internal Medicine, Hiroshima International University, Kure, Japan. t-shima@ns.hirokoku-u.ac.jp
• J. Gastroenterol. Hepatol. 2012 May 1; 27 (5): 899-906.

Background And AimWe aimed to determine whether reflux- and symptom-related parameters can predict the efficacy of proton pump inhibitors (PPI) in non-erosive reflux disease (NERD).MethodsTwenty-seven NERD patients who had experienced heartburn more than once a week within the previous month were enrolled. Intraesophageal pH before therapy was measured simultaneously at 5 and 15 cm above the esophagogastric junction (EGJ) for 24 h. The PPI rabeprazole was administered at a dose of 10 mg once daily for 4 weeks. In the event that heartburn was not relieved, the dose was increased to 10 mg twice daily for an additional 2 weeks, and again to 20 mg twice daily for another 2 weeks.ResultsUnivariate analysis demonstrated no significant associations between any reflux- or symptom-related parameters at either site and complete heartburn relief after 4 weeks, or cumulative complete heartburn relief after 8 weeks. However, post-hoc analysis demonstrated more satisfactory heartburn relief after 4 weeks in patients with a high symptom index compared with those with a low symptom index, at 5 cm above the EGJ (P = 0.009). Cumulative satisfactory heartburn relief after 8 weeks was also greater in patients with a high total number of acid reflux episodes compared with those with a low total number of episodes, at 15 cm above the EGJ (P = 0.037).ConclusionsPre-therapeutic pH monitoring in the lower and mid-esophagus is useful for predicting the efficacy of PPI in NERD patients.© 2011 Journal of Gastroenterology and Hepatology Foundation and Blackwell Publishing Asia Pty Ltd.

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