title: The Prevalence and Clinical Features of Non-responsive Gastroesophageal Reflux Disease to Practical Proton Pump Inhibitor Dose in Korea: A Multicenter Study.
abstract: OBJECTIVE
  In Korea, there are no available multicenter data concerning the prevalence of or diagnostic approaches for non-responsive gastroesophageal reflux disease (GERD) which does not respond to practical dose of proton pump inhibitor (PPI) in Korea. The purpose of this study is to evaluate the prevalence and the symptom pattern of non-responsive GERD.
  
  
  METHODS
  A total of 12 hospitals who were members of a Korean GERD research group joined this study. We used the composite score (CS) as a reflux symptom scale which is a standardized questionnaire based on the frequency and severity of typical symptoms of GERD. We defined "non-responsive GERD" as follows: a subject with the erosive reflux disease (ERD) whose CS was not decreased by at least 50% after standard-dose PPIs for 8 weeks or a subject with non-erosive reflux disease (NERD) whose CS was not decreased by at least 50% after half-dose PPIs for 4 weeks.
  
  
  RESULTS
  A total of 234 subjects were analyzed. Among them, 87 and 147 were confirmed to have ERD and NERD, respectively. The prevalence of non-responsive GERD was 26.9% (63/234). The rates of non-responsive GERD were not different between the ERD and NERD groups (25.3% vs. 27.9%, respectively, p=0.664). There were no differences between the non-responsive GERD and responsive GERD groups for sex (p=0.659), age (p=0.134), or BMI (p=0.209). However, the initial CS for epigastric pain and fullness were higher in the non-responsive GERD group (p=0.044, p=0.014, respectively).
  
  
  CONCLUSIONS
  In conclusion, this multicenter Korean study showed that the rate of non-responsive GERD was substantially high up to 26%. In addition, the patients with the non-responsive GERD frequently showed dyspeptic symptoms such as epigastric pain and fullness.
authors.affiliation: Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea.
authors.forename: Hong Jun
authors.initials: HJ
authors.lastname: Park
authors.affiliation: Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Korea.
authors.forename: Soo Heon
authors.initials: SH
authors.lastname: Park
authors.affiliation: Department of Internal Medicine, Ewha Womans University School of Medicine, Seoul, Korea.
authors.forename: Ki Nam
authors.initials: KN
authors.lastname: Shim
authors.affiliation: Department of Internal Medicine, Wonkwang University Sanbon Hospital, Gunpo, Korea.
authors.forename: Yong Sung
authors.initials: YS
authors.lastname: Kim
authors.affiliation: Department of Internal Medicine, Gyeongsang National University School of Medicine, Jinju, Korea.
authors.forename: Hyun Jin
authors.initials: HJ
authors.lastname: Kim
authors.affiliation: Department of Internal Medicine, Soonchunhyang University College of Medicine, Bucheon, Korea.
authors.forename: Jae Pil
authors.initials: JP
authors.lastname: Han
authors.affiliation: Department of Internal Medicine, Eulji University, Seoul, Korea.
authors.forename: Yong Sik
authors.initials: YS
authors.lastname: Kim
authors.affiliation: Department of Internal Medicine, Inha University School of Medicine, Incheon, Korea.
authors.forename: Byoung Wook
authors.initials: BW
authors.lastname: Bang
authors.affiliation: Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea.
authors.forename: Gwang Ha
authors.initials: GH
authors.lastname: Kim
authors.affiliation: Department of Internal Medicine, Hallym University College of Medicine, Chuncheon, Korea.
authors.forename: Gwang Ho
authors.initials: GH
authors.lastname: Baik
authors.affiliation: Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Korea.
authors.forename: Hyung Hun
authors.initials: HH
authors.lastname: Kim
authors.affiliation: Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea.
authors.forename: Seon Young
authors.initials: SY
authors.lastname: Park
authors.affiliation: Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Korea.
authors.forename: Sung Soo
authors.initials: SS
authors.lastname: Kim
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D005764:Gastroesophageal Reflux / Q000188:drug therapy* / Q000453:epidemiology* / Q000473:pathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D054328:Proton Pump Inhibitors / Q000627:therapeutic use*; D056910:Republic of Korea / Q000453:epidemiology; D016896:Treatment Outcome
chemical_list: D054328:Proton Pump Inhibitors
keywords: Gastric acid; Gastroesophageal reflux; Heartburn; Proton pump inhibitors; Reflux esophagitis