title: The GerdQ questionnaire and high resolution manometry support the hypothesis that proton pump inhibitor-responsive oesophageal eosinophilia is a GERD-related phenomenon.
abstract: Little is known about the relationship between proton pump inhibitor-responsive oesophageal eosinophilia (PPI-REE), eosinophilic esophagitis (EoE) and gastro-oesophageal reflux disease (GERD).
  
  
  
  To compare high resolution manometry features and symptom profiles of patients with EoE, PPI-REE and GERD.
  
  
  
  Consecutive patients diagnosed with EoE or PPI-REE according to international criteria (presence of at least one typical symptom of oesophageal dysfunction; at least 15 eosinophils per high-power field at mid/proximal oesophagus, persistence or resolution of eosinophils after an 8-week PPI trial), and a group of patients with proven GERD and oesophageal eosinophilia, prospectively completed the GerdQ questionnaire and underwent high resolution manometry.
  
  
  
  Thirty-five patients with EoE, 17 with PPI-REE and 27 with GERD were enrolled. When compared to GERD, both EoE and PPI-REE had higher rates of dysphagia (15% vs. 94% vs. 88%, P < 0.0001), patients with EoE reported heartburn and regurgitation less frequently (26% vs. 85%, and 17% vs. 74%, respectively; P < 0.001 for each and had lower GerdQ score [1 (0-6) vs. 8 (6-12), P < 0.001] than GERD patients. There was no significant difference comparing PPI-REE and GERD patients. Patients with PPI-REE had a higher prevalence of erosive oesophagitis than patients with EoE (35% vs. 9%, P = 0.04), which was similar to that of GERD (48%, P = 0.54). Patients with EoE had a lower frequency of high resolution manometry features associated with GERD than patients with PPI-REE. There was no significant difference between PPI-REE and GERD patients.
  
  
  
  GERD, as assessed by GerdQ and high resolution manometry is common in patients with PPI-REE, which may share similar pathogenic mechanisms.
authors.affiliation: Division of Gastroenterology, Department of Surgery, Oncology and Gastroenterology, University of Padua, Padua, Italy.
authors.forename: E V
authors.initials: EV
authors.lastname: Savarino
authors.affiliation: Division of General and Bariatric Surgery, Department of Surgery, Second University of Naples, Naples, Italy.
authors.forename: S
authors.initials: S
authors.lastname: Tolone
authors.affiliation: Division of Gastroenterology, Department of Surgery, Oncology and Gastroenterology, University of Padua, Padua, Italy.
authors.forename: O
authors.initials: O
authors.lastname: Bartolo
authors.affiliation: Division of Gastroenterology, Department of Surgery, Oncology and Gastroenterology, University of Padua, Padua, Italy.
authors.forename: C
authors.initials: C
authors.lastname: de Cassan
authors.affiliation: Division of Gastroenterology, Department of Surgery, Oncology and Gastroenterology, University of Padua, Padua, Italy.
authors.forename: R
authors.initials: R
authors.lastname: Caccaro
authors.affiliation: Division of Gastroenterology, Department of Surgery, Oncology and Gastroenterology, University of Padua, Padua, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Galeazzi
authors.affiliation: U.O. Clinica Chirurgica 3, Department of Surgery, Oncology and Gastroenterology, University of Padua, Padua, Italy.
authors.forename: L
authors.initials: L
authors.lastname: Nicoletti
authors.affiliation: U.O. Clinica Chirurgica 3, Department of Surgery, Oncology and Gastroenterology, University of Padua, Padua, Italy.
authors.forename: R
authors.initials: R
authors.lastname: Salvador
authors.affiliation: Division of Gastroenterology, Department of Surgery, Oncology and Gastroenterology, University of Padua, Padua, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Martinato
authors.affiliation: U.O. Clinica Chirurgica 3, Department of Surgery, Oncology and Gastroenterology, University of Padua, Padua, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Costantini
authors.affiliation: Division of Gastroenterology, Department of Internal Medicine, University of Genoa, Genoa, Italy.
authors.forename: V
authors.initials: V
authors.lastname: Savarino
mesh_terms: D000328:Adult; D000368:Aged; D003680:Deglutition Disorders / Q000175:diagnosis / Q000188:drug therapy; D057765:Eosinophilic Esophagitis / Q000175:diagnosis / Q000188:drug therapy*; D005260:Female; D005764:Gastroesophageal Reflux / Q000175:diagnosis / Q000188:drug therapy*; D006356:Heartburn / Q000175:diagnosis / Q000188:drug therapy; D006801:Humans; D008297:Male; D008365:Manometry / Q000379:methods*; D008875:Middle Aged; D011446:Prospective Studies; D054328:Proton Pump Inhibitors / Q000627:therapeutic use*; D011795:Surveys and Questionnaires
chemical_list: D054328:Proton Pump Inhibitors