title: Characteristics of non-erosive gastroesophageal reflux disease refractory to proton pump inhibitor therapy.
abstract: OBJECTIVE
  To investigate whether potent acid inhibition is effective in non-erosive reflux disease (NERD) refractory to standard rabeprazole (RPZ) treatment.
  
  
  METHODS
  We treated 10 Japanese patients with NERD resistant to standard dosages of RPZ: 10 mg or 20 mg od, 20 mg bid, or 10 mg qid for 14 d. All patients completed a frequency scale for symptoms of gastroesophageal reflux disease questionnaire frequency scale for the symptoms of GERD (FSSG); and underwent 24 h pH monitoring on day 14.
  
  
  RESULTS
  With increased dosages and frequency of administration of RPZ, median intragastric pH significantly increased, and FSSG scores significantly decreased. With RPZ 10 mg qid, potent acid inhibition was attained throughout 24 h. However, five subjects were refractory to RPZ 10 mg qid, although the median intragastric pH in these subjects (6.6, range: 6.2-7.1) was similar to that in the remaining five responsive subjects (6.5, range: 5.3-7.3). With baseline RPZ 10 mg od, FSSG scores in responsive patients improved by > 30%, whereas there was no significant decrease in the resistant group.
  
  
  CONCLUSIONS
  NERD patients whose FSSG score fails to decrease by > 30% after treatment with RPZ 10 mg od for 14 d are refractory to higher dosage.
authors.affiliation: Center for Clinical Research, Hamamatsu University School of Medicine, Shizuoka Hamamatsu 431-3192, Japan. mitsu@hama-med.ac.jp
authors.forename: Mitsushige
authors.initials: M
authors.lastname: Sugimoto
authors.forename: Masafumi
authors.initials: M
authors.lastname: Nishino
authors.forename: Chise
authors.initials: C
authors.lastname: Kodaira
authors.forename: Mihoko
authors.initials: M
authors.lastname: Yamade
authors.forename: Takahiro
authors.initials: T
authors.lastname: Uotani
authors.forename: Mutsuhiro
authors.initials: M
authors.lastname: Ikuma
authors.forename: Kazuo
authors.initials: K
authors.lastname: Umemura
authors.forename: Takahisa
authors.initials: T
authors.lastname: Furuta
mesh_terms: D053799:2-Pyridinylmethylsulfinylbenzimidazoles / Q000627:therapeutic use; D000293:Adolescent; D000328:Adult; D000897:Anti-Ulcer Agents / Q000627:therapeutic use; D004351:Drug Resistance; D005764:Gastroesophageal Reflux / Q000175:diagnosis / Q000628:therapy*; D006801:Humans; D006863:Hydrogen-Ion Concentration; D054328:Proton Pump Inhibitors / Q000627:therapeutic use*; D064750:Rabeprazole; D055815:Young Adult
chemical_list: D053799:2-Pyridinylmethylsulfinylbenzimidazoles; D000897:Anti-Ulcer Agents; D054328:Proton Pump Inhibitors; D064750:Rabeprazole