title: Influence of irritable bowel syndrome on treatment outcome in gastroesophageal reflux disease.
abstract: OBJECTIVE
  To investigate the influence of irritable bowel syndrome (IBS)-like symptoms on treatment outcomes with pantoprazole in gastroesophageal reflux disease (GERD) in a real life setting.
  
  
  METHODS
  For this prospective, open-label, multinational, multicentre study, 1888 patients assessed by the investigators as suffering from GERD were recruited. The patients were additionally classified as with or without IBS-like symptoms at baseline. They were treated with pantoprazole 40 mg once daily and completed the Reflux Questionnaire™ (ReQuest™) short version daily. Response rates and symptom scores were compared after 4 and 8 wk of treatment for subgroups defined by the subclasses of GERD [erosive (ERD) and non-erosive reflux disease (NERD)] and the presence of IBS-like symptoms.
  
  
  RESULTS
  IBS-like symptoms were more prevalent in NERD than in ERD (18.3% vs 12.7%, P = 0.0015). Response rates after 4 and/or 8 wk of treatment were lower in patients with IBS-like symptoms than in patients without IBS-like symptoms in both ERD (Week 4: P < 0.0001, Week 8: P < 0.0339) and NERD (Week 8: P = 0.0088). At baseline, ReQuest™ "lower abdominal complaints" symptom scores were highest in NERD patients with IBS-like symptoms. Additionally, these patients had the strongest symptom improvement after treatment compared with all other subgroups.
  
  
  CONCLUSIONS
  IBS-like symptoms influence treatment outcome and symptom burden in GERD and should be considered in management. Proton pump inhibitors can improve IBS-like symptoms, particularly in NERD.
authors.affiliation: Department of Medicine, Martin-Luther Hospital, Academic Teaching Hospital of Charité, Universitätsmedizin, 14193 Berlin, Germany. moennikes@web.de
authors.forename: Hubert
authors.initials: H
authors.lastname: Mönnikes
authors.forename: Robert C
authors.initials: RC
authors.lastname: Heading
authors.forename: Holger
authors.initials: H
authors.lastname: Schmitt
authors.forename: Hubert
authors.initials: H
authors.lastname: Doerfler
mesh_terms: D053799:2-Pyridinylmethylsulfinylbenzimidazoles / Q000627:therapeutic use*; D000328:Adult; D000897:Anti-Ulcer Agents / Q000627:therapeutic use*; D015897:Comorbidity; D004941:Esophagitis / Q000150:complications; D005260:Female; D005764:Gastroesophageal Reflux / Q000150:complications* / Q000188:drug therapy*; D006801:Humans; D007391:International Cooperation; D043183:Irritable Bowel Syndrome / Q000150:complications* / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D000077402:Pantoprazole; D011446:Prospective Studies; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
chemical_list: D053799:2-Pyridinylmethylsulfinylbenzimidazoles; D000897:Anti-Ulcer Agents; D000077402:Pantoprazole