title: Clinical Characteristics of Patients with Gastroesophageal Reflux Disease Refractory to Proton Pump Inhibitors and the Effects of Switching to 20 mg Esomeprazole on Reflux Symptoms and Quality of Life.
abstract: BACKGROUND Refractory gastroesophageal reflux disease (GERD) may deteriorate patient quality of life (QOL) despite proton pump inhibitor (PPI) therapy. MATERIAL AND METHODS Nineteen Japanese institutions were surveyed to determine the clinical characteristics and QOL of patients with refractory GERD. Those patients treated with a conventional PPI were switched to 20 mg esomeprazole for 4 weeks. Symptoms and QOL were assessed using Global Overall Symptom and Gastrointestinal Symptom Rating Scale (GSRS) questionnaires at baseline and at 2 and/or 4 weeks of esomeprazole treatment. RESULTS Of 120 patients who completed the survey, 58 (48.3%) had refractory GERD. Of these, 69.0% were aged ≥ 65 years, 79.3% were prescribed a PPI at a standard or high dose, and 22.4% were prescribed a PPI together with another drug. After switching to esomeprazole, patients reported significant improvements in heartburn, acid regurgitation, and excessive belching at 2 weeks using a symptom diary, as well as the total score, reflux, abdominal pain, and indigestion, which were assessed using the GSRS at 4 weeks. CONCLUSIONS About half of Japanese patients with GERD may be refractory to conventional PPIs. Their reflux-related symptoms are often severe and may impair QOL. Switching to esomeprazole could be used to improve their symptoms and QOL.
authors.affiliation: Department of Gastroenterology and Hepatology, Nagasaki University Hospital, Nagasaki, Japan.
authors.forename: Fuminao
authors.initials: F
authors.lastname: Takeshima
authors.affiliation: Department of Gastroenterology and Hepatology, Nagasaki University Hospital, Nagasaki, Japan.
authors.forename: Keiichi
authors.initials: K
authors.lastname: Hashiguchi
authors.affiliation: Department of Internal Medicine, Onitsuka Clinic of Internal Medicine, Nagasaki, Japan.
authors.forename: Yasunori
authors.initials: Y
authors.lastname: Onitsuka
authors.affiliation: Department of Gastroenterology and Hepatology, Tanigawa Clinic of Radiology and Gastroenterology, Nagasaki, Japan.
authors.forename: Ken
authors.initials: K
authors.lastname: Tanigawa
authors.affiliation: 0.
authors.forename: Hitomi
authors.initials: H
authors.lastname: Minami
authors.affiliation: Department of Gastroenterology and Hepatology, Nagasaki University Hospital, Nagasaki, Japan.
authors.forename: Kayoko
authors.initials: K
authors.lastname: Matsushima
authors.affiliation: Department of Gastroenterology and Hepatology, Nagasaki University Hospital, Nagasaki, Japan.
authors.forename: Yuko
authors.initials: Y
authors.lastname: Akazawa
authors.affiliation: 0.
authors.forename: Ken
authors.initials: K
authors.lastname: Shiozawa
authors.affiliation: Department of Gastroenterology and Hepatology, Nagasaki University Hospital, Nagasaki, Japan.
authors.forename: Naoyuki
authors.initials: N
authors.lastname: Yamaguchi
authors.affiliation: Department of Gastroenterology and Hepatology, Nagasaki University Hospital, Nagasaki, Japan.
authors.forename: Naota
authors.initials: N
authors.lastname: Taura
authors.affiliation: Department of Gastroenterology and Hepatology, Nagasaki University Hospital, Nagasaki, Japan.
authors.forename: Ken
authors.initials: K
authors.lastname: Ohnita
authors.affiliation: 0.
authors.forename: Tatsuki
authors.initials: T
authors.lastname: Ichikawa
authors.affiliation: Department of Gastroenterology and Hepatology, Nagasaki University Hospital, Nagasaki, Japan.
authors.forename: Hajime
authors.initials: H
authors.lastname: Isomoto
authors.affiliation: Department of Gastroenterology and Hepatology, Nagasaki University Hospital, Nagasaki, Japan.
authors.forename: Kazuhiko
authors.initials: K
authors.lastname: Nakao
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D064098:Esomeprazole / Q000627:therapeutic use*; D005260:Female; D005764:Gastroesophageal Reflux / Q000188:drug therapy* / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D054328:Proton Pump Inhibitors / Q000627:therapeutic use*; D011788:Quality of Life; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
chemical_list: D054328:Proton Pump Inhibitors; D064098:Esomeprazole