[Utility of rabeprazole as a diagnostic test in non-erosive gastroesophageal reflux disease].
BACKGROUND
Proton pump inhibitor test (PPIt) has been shown adequate diagnostic usefulness and cost-effectiveness in the evaluation of patients with gastroesophageal reflux disease (GERD). However, comparative studies of PPIt with 24 hr esophageal pH-metry (24-pH) in non erosive GERD (NERD) are scarce and the utility of rabeprazole as a PPIt has not been evaluated.


OBJECTIVE
To investigate the diagnostic utility of rabeprazole test in patients with NERD.


METHODS
An open label trial was performed, and NERD patients with heartburn at least 3 times per week were included. Symptomatic evaluation before, during and after rabeprazole 20 mg bid for 7 days was performed. All patients underwent 24-pH before treatment with rabeprazole. Patients were classified in three groups: 1) abnormal pH, 2) normal pH and symptom index (SI) positive, and 3) normal pH and SI negative. A positive rabrepazole test was considered when symptoms improvement was higher than 50% at the end of the test. Sensitivity, specificity, negative predictive value, positive predictive value and positive likelihood ratio were calculated considering the 24-pH as gold standard.


RESULTS
Sixty four patients, 47 (72%) female were studied. Forty four percent of the patients had normal pH, 29% with SI positive and 71% with SI negative. Sensitivity, specificity, positive predictive value, negative predictive value and positive likelihood ratio were 82%, 47%, 78%, 52% and 1.406 respectively. No adverse events were reported.


CONCLUSIONS
PPI test with rabeprazole 20 mg bid for 7 days is a simple and useful test in the diagnostic approach of patients with NERD.
Remes-Troche
José María
JM
Departamento de Gastroenterología, Instituto Nacional de Ciencias Médicas y Nutrición, Salvador Zubirán, Tlalpan, México, D.F.
Carmona-Sánchez
Ramón
R
Soto Pérez
Julio César
JC
González Martínez
Marina
M
Icaza Chávez
María Eugenia
ME
Torres Barrera
Gustavo
G
Sánchez Morrill
Augusto
A
Valdovinos Díaz
Miguel Angel
MA
D053799:2-Pyridinylmethylsulfinylbenzimidazoles; D000293:Adolescent; D000328:Adult; D005260:Female; D005764:Gastroesophageal Reflux / Q000175:diagnosis*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D006180:Proton-Translocating ATPases / Q000037:antagonists & inhibitors*; D064750:Rabeprazole
D053799:2-Pyridinylmethylsulfinylbenzimidazoles; D064750:Rabeprazole; D006180:Proton-Translocating ATPases