title: Predicting the efficacy of proton pump inhibitors in patients with non-erosive reflux disease before therapy using dual-channel 24-h esophageal pH monitoring.
abstract: OBJECTIVE
  We aimed to determine whether reflux- and symptom-related parameters can predict the efficacy of proton pump inhibitors (PPI) in non-erosive reflux disease (NERD).
  
  
  METHODS
  Twenty-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.
  
  
  RESULTS
  Univariate 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).
  
  
  CONCLUSIONS
  Pre-therapeutic pH monitoring in the lower and mid-esophagus is useful for predicting the efficacy of PPI in NERD patients.
authors.affiliation: Division of Adult Nursing and Internal Medicine, Hiroshima International University, Kure, Japan. t-shima@ns.hirokoku-u.ac.jp
authors.forename: Tomohiko
authors.initials: T
authors.lastname: Shimatani
authors.forename: Mitsushige
authors.initials: M
authors.lastname: Sugimoto
authors.forename: Masafumi
authors.initials: M
authors.lastname: Nishino
authors.forename: Kyoichi
authors.initials: K
authors.lastname: Adachi
authors.forename: Kenji
authors.initials: K
authors.lastname: Furuta
authors.forename: Masanori
authors.initials: M
authors.lastname: Ito
authors.forename: Susumu
authors.initials: S
authors.lastname: Kurosawa
authors.forename: Noriaki
authors.initials: N
authors.lastname: Manabe
authors.forename: Kotaro
authors.initials: K
authors.lastname: Mannen
authors.forename: Michio
authors.initials: M
authors.lastname: Hongo
authors.forename: Tsutomu
authors.initials: T
authors.lastname: Chiba
authors.forename: Yoshikazu
authors.initials: Y
authors.lastname: Kinoshita
mesh_terms: D053799:2-Pyridinylmethylsulfinylbenzimidazoles / Q000627:therapeutic use*; D000293:Adolescent; D000328:Adult; D016009:Chi-Square Distribution; D050782:Esophageal pH Monitoring; D005260:Female; D005764:Gastroesophageal Reflux / Q000150:complications / Q000188:drug therapy*; D006356:Heartburn / Q000188:drug therapy* / Q000209:etiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D011237:Predictive Value of Tests; D054328:Proton Pump Inhibitors / Q000627:therapeutic use*; D064750:Rabeprazole; D012720:Severity of Illness Index; D055815:Young Adult
chemical_list: D053799:2-Pyridinylmethylsulfinylbenzimidazoles; D054328:Proton Pump Inhibitors; D064750:Rabeprazole