Correlation between oesophageal acid exposure and dyspeptic symptoms in patients with nonerosive reflux disease.
OBJECTIVE
Oesophageal acidification induces dyspeptic symptoms in healthy individuals. This study aimed to evaluate the correlation between oesophageal acid exposure and dyspeptic symptoms in patients with nonerosive reflux disease.


METHODS
A total of 68 patients with dominant symptoms of heartburn, negative upper gastrointestinal endoscopy and concomitant dyspeptic symptoms participated in the study. The severity of dyspepsia and reflux-related symptoms was evaluated, and 24-h gastro-oesophageal pH-monitoring study was performed in all patients at baseline and after 4 weeks of therapy with esomeprazole 40 mg.


RESULTS
Oesophageal basal acid exposure was pathological in 43 patients and normal in 25 patients, with a similar prevalence and severity of individual dyspeptic symptoms in the two groups. A significant correlation between reflux and dyspepsia scores was observed in the subgroup of patients with normal, but not in those with abnormal pHmetry (r=0.4, P=0.04 and r=0.2 P=0.07, respectively). After esomeprazole, a reduction in severity of dyspepsia (>or=50% with respect to baseline) was observed, independent of improvement of reflux-associated symptoms. Improvement in dyspepsia was, however, similar in patients with normal and abnormal basal acid exposure (14/25 vs. 33/43, respectively, P=NS).


CONCLUSIONS
Dyspeptic symptoms coexist in a subset of nonerosive reflux disease patients, but prevalence and severity of the symptoms seems to be independent of oesophageal acid exposure.
Sarnelli
Giovanni
G
Gastroenterology Unit, Department of Clinical and Experimental Medicine, Federico II University, Naples, Italy.
De Giorgi
Francesco
F
Efficie
Eleonora
E
Aprea
Giovanni
G
Masone
Stefania
S
Savarese
Maria Flavia
MF
Esposito
Ida
I
Russo
Luigi
L
Cuomo
Rosario
R
D000897:Anti-Ulcer Agents / Q000627:therapeutic use; D004415:Dyspepsia / Q000188:drug therapy / Q000209:etiology*; D064098:Esomeprazole / Q000627:therapeutic use; D050782:Esophageal pH Monitoring / Q000295:instrumentation; D005260:Female; D005744:Gastric Acid / Q000378:metabolism* / Q000502:physiology; D005764:Gastroesophageal Reflux / Q000150:complications* / Q000188:drug therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D054328:Proton Pump Inhibitors / Q000627:therapeutic use*; D016896:Treatment Outcome
D000897:Anti-Ulcer Agents; D054328:Proton Pump Inhibitors; D064098:Esomeprazole