title: Factors associated with residual gastroesophageal reflux disease symptoms in patients receiving proton pump inhibitor maintenance therapy.
abstract: OBJECTIVE
  To elucidate the factors associated with residual gastroesophageal reflux disease (GERD) symptoms in patients receiving proton pump inhibitor (PPI) maintenance therapy in clinical practice.
  
  
  METHODS
  The study included 39 GERD patients receiving maintenance PPI therapy. Residual symptoms were assessed using the Frequency Scale for Symptoms of GERD (FSSG) questionnaire and the Gastrointestinal Symptom Rating Scale (GSRS). The relationships between the FSSG score and patient background factors, including the CYP2C19 genotype, were analyzed.
  
  
  RESULTS
  The FSSG scores ranged from 1 to 28 points (median score: 7.5 points), and 19 patients (48.7%) had a score of 8 points or more. The patients' GSRS scores were significantly correlated with their FSSG scores (correlation coefficient = 0.47,P< 0.005). In erosive esophagitis patients, the FSSG scores of the CYP2C19 rapid metabolizers (RMs) were significantly higher than the scores of the poor metabolizers and intermediate metabolizers (total scores: 16.7 ± 8.6vs7.8 ± 5.4,P< 0.05; acid reflux-related symptom scores: 12 ± 1.9vs2.5 ± 0.8,P< 0.005). In contrast, the FSSG scores of the CYP2C19 RMs in the non-erosive reflux disease patients were significantly lower than those of the other patients (total scores: 5.5 ± 1.0vs11.8 ± 6.3,P< 0.05; dysmotility symptom-related scores: 1.0 ± 0.4vs6.0 ± 0.8,P< 0.01).
  
  
  CONCLUSIONS
  Approximately half of the GERD patients receiving maintenance PPI therapy had residual symptoms associated with a lower quality of life, and the CYP2C19 genotype appeared to be associated with these residual symptoms.
authors.affiliation: Fumiaki Kawara, Tsuyoshi Fujita, Yoshinori Morita, Atsuhiro Masuda, Masaya Saito, Makoto Ooi, Tsukasa Ishida, Yasuyuki Kondo, Shiei Yoshida, Tatsuya Okuno, Yoshihiko Yano, Masaru Yoshida, Hiromu Kutsumi, Takanobu Hayakumo, Takeshi Azuma, Division of Gastroenterology, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe, Hyogo 650-0017, Japan.
authors.forename: Fumiaki
authors.initials: F
authors.lastname: Kawara
authors.affiliation: Fumiaki Kawara, Tsuyoshi Fujita, Yoshinori Morita, Atsuhiro Masuda, Masaya Saito, Makoto Ooi, Tsukasa Ishida, Yasuyuki Kondo, Shiei Yoshida, Tatsuya Okuno, Yoshihiko Yano, Masaru Yoshida, Hiromu Kutsumi, Takanobu Hayakumo, Takeshi Azuma, Division of Gastroenterology, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe, Hyogo 650-0017, Japan.
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Fujita
authors.affiliation: Fumiaki Kawara, Tsuyoshi Fujita, Yoshinori Morita, Atsuhiro Masuda, Masaya Saito, Makoto Ooi, Tsukasa Ishida, Yasuyuki Kondo, Shiei Yoshida, Tatsuya Okuno, Yoshihiko Yano, Masaru Yoshida, Hiromu Kutsumi, Takanobu Hayakumo, Takeshi Azuma, Division of Gastroenterology, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe, Hyogo 650-0017, Japan.
authors.forename: Yoshinori
authors.initials: Y
authors.lastname: Morita
authors.affiliation: Fumiaki Kawara, Tsuyoshi Fujita, Yoshinori Morita, Atsuhiro Masuda, Masaya Saito, Makoto Ooi, Tsukasa Ishida, Yasuyuki Kondo, Shiei Yoshida, Tatsuya Okuno, Yoshihiko Yano, Masaru Yoshida, Hiromu Kutsumi, Takanobu Hayakumo, Takeshi Azuma, Division of Gastroenterology, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe, Hyogo 650-0017, Japan.
authors.forename: Atsushi
authors.initials: A
authors.lastname: Uda
authors.affiliation: Fumiaki Kawara, Tsuyoshi Fujita, Yoshinori Morita, Atsuhiro Masuda, Masaya Saito, Makoto Ooi, Tsukasa Ishida, Yasuyuki Kondo, Shiei Yoshida, Tatsuya Okuno, Yoshihiko Yano, Masaru Yoshida, Hiromu Kutsumi, Takanobu Hayakumo, Takeshi Azuma, Division of Gastroenterology, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe, Hyogo 650-0017, Japan.
authors.forename: Atsuhiro
authors.initials: A
authors.lastname: Masuda
authors.affiliation: Fumiaki Kawara, Tsuyoshi Fujita, Yoshinori Morita, Atsuhiro Masuda, Masaya Saito, Makoto Ooi, Tsukasa Ishida, Yasuyuki Kondo, Shiei Yoshida, Tatsuya Okuno, Yoshihiko Yano, Masaru Yoshida, Hiromu Kutsumi, Takanobu Hayakumo, Takeshi Azuma, Division of Gastroenterology, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe, Hyogo 650-0017, Japan.
authors.forename: Masaya
authors.initials: M
authors.lastname: Saito
authors.affiliation: Fumiaki Kawara, Tsuyoshi Fujita, Yoshinori Morita, Atsuhiro Masuda, Masaya Saito, Makoto Ooi, Tsukasa Ishida, Yasuyuki Kondo, Shiei Yoshida, Tatsuya Okuno, Yoshihiko Yano, Masaru Yoshida, Hiromu Kutsumi, Takanobu Hayakumo, Takeshi Azuma, Division of Gastroenterology, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe, Hyogo 650-0017, Japan.
authors.forename: Makoto
authors.initials: M
authors.lastname: Ooi
authors.affiliation: Fumiaki Kawara, Tsuyoshi Fujita, Yoshinori Morita, Atsuhiro Masuda, Masaya Saito, Makoto Ooi, Tsukasa Ishida, Yasuyuki Kondo, Shiei Yoshida, Tatsuya Okuno, Yoshihiko Yano, Masaru Yoshida, Hiromu Kutsumi, Takanobu Hayakumo, Takeshi Azuma, Division of Gastroenterology, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe, Hyogo 650-0017, Japan.
authors.forename: Tsukasa
authors.initials: T
authors.lastname: Ishida
authors.affiliation: Fumiaki Kawara, Tsuyoshi Fujita, Yoshinori Morita, Atsuhiro Masuda, Masaya Saito, Makoto Ooi, Tsukasa Ishida, Yasuyuki Kondo, Shiei Yoshida, Tatsuya Okuno, Yoshihiko Yano, Masaru Yoshida, Hiromu Kutsumi, Takanobu Hayakumo, Takeshi Azuma, Division of Gastroenterology, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe, Hyogo 650-0017, Japan.
authors.forename: Yasuyuki
authors.initials: Y
authors.lastname: Kondo
authors.affiliation: Fumiaki Kawara, Tsuyoshi Fujita, Yoshinori Morita, Atsuhiro Masuda, Masaya Saito, Makoto Ooi, Tsukasa Ishida, Yasuyuki Kondo, Shiei Yoshida, Tatsuya Okuno, Yoshihiko Yano, Masaru Yoshida, Hiromu Kutsumi, Takanobu Hayakumo, Takeshi Azuma, Division of Gastroenterology, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe, Hyogo 650-0017, Japan.
authors.forename: Shiei
authors.initials: S
authors.lastname: Yoshida
authors.affiliation: Fumiaki Kawara, Tsuyoshi Fujita, Yoshinori Morita, Atsuhiro Masuda, Masaya Saito, Makoto Ooi, Tsukasa Ishida, Yasuyuki Kondo, Shiei Yoshida, Tatsuya Okuno, Yoshihiko Yano, Masaru Yoshida, Hiromu Kutsumi, Takanobu Hayakumo, Takeshi Azuma, Division of Gastroenterology, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe, Hyogo 650-0017, Japan.
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Okuno
authors.affiliation: Fumiaki Kawara, Tsuyoshi Fujita, Yoshinori Morita, Atsuhiro Masuda, Masaya Saito, Makoto Ooi, Tsukasa Ishida, Yasuyuki Kondo, Shiei Yoshida, Tatsuya Okuno, Yoshihiko Yano, Masaru Yoshida, Hiromu Kutsumi, Takanobu Hayakumo, Takeshi Azuma, Division of Gastroenterology, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe, Hyogo 650-0017, Japan.
authors.forename: Yoshihiko
authors.initials: Y
authors.lastname: Yano
authors.affiliation: Fumiaki Kawara, Tsuyoshi Fujita, Yoshinori Morita, Atsuhiro Masuda, Masaya Saito, Makoto Ooi, Tsukasa Ishida, Yasuyuki Kondo, Shiei Yoshida, Tatsuya Okuno, Yoshihiko Yano, Masaru Yoshida, Hiromu Kutsumi, Takanobu Hayakumo, Takeshi Azuma, Division of Gastroenterology, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe, Hyogo 650-0017, Japan.
authors.forename: Masaru
authors.initials: M
authors.lastname: Yoshida
authors.affiliation: Fumiaki Kawara, Tsuyoshi Fujita, Yoshinori Morita, Atsuhiro Masuda, Masaya Saito, Makoto Ooi, Tsukasa Ishida, Yasuyuki Kondo, Shiei Yoshida, Tatsuya Okuno, Yoshihiko Yano, Masaru Yoshida, Hiromu Kutsumi, Takanobu Hayakumo, Takeshi Azuma, Division of Gastroenterology, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe, Hyogo 650-0017, Japan.
authors.forename: Hiromu
authors.initials: H
authors.lastname: Kutsumi
authors.affiliation: Fumiaki Kawara, Tsuyoshi Fujita, Yoshinori Morita, Atsuhiro Masuda, Masaya Saito, Makoto Ooi, Tsukasa Ishida, Yasuyuki Kondo, Shiei Yoshida, Tatsuya Okuno, Yoshihiko Yano, Masaru Yoshida, Hiromu Kutsumi, Takanobu Hayakumo, Takeshi Azuma, Division of Gastroenterology, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe, Hyogo 650-0017, Japan.
authors.forename: Takanobu
authors.initials: T
authors.lastname: Hayakumo
authors.affiliation: Fumiaki Kawara, Tsuyoshi Fujita, Yoshinori Morita, Atsuhiro Masuda, Masaya Saito, Makoto Ooi, Tsukasa Ishida, Yasuyuki Kondo, Shiei Yoshida, Tatsuya Okuno, Yoshihiko Yano, Masaru Yoshida, Hiromu Kutsumi, Takanobu Hayakumo, Takeshi Azuma, Division of Gastroenterology, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe, Hyogo 650-0017, Japan.
authors.forename: Kazuhiko
authors.initials: K
authors.lastname: Yamashita
authors.affiliation: Fumiaki Kawara, Tsuyoshi Fujita, Yoshinori Morita, Atsuhiro Masuda, Masaya Saito, Makoto Ooi, Tsukasa Ishida, Yasuyuki Kondo, Shiei Yoshida, Tatsuya Okuno, Yoshihiko Yano, Masaru Yoshida, Hiromu Kutsumi, Takanobu Hayakumo, Takeshi Azuma, Division of Gastroenterology, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe, Hyogo 650-0017, Japan.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Hirano
authors.affiliation: Fumiaki Kawara, Tsuyoshi Fujita, Yoshinori Morita, Atsuhiro Masuda, Masaya Saito, Makoto Ooi, Tsukasa Ishida, Yasuyuki Kondo, Shiei Yoshida, Tatsuya Okuno, Yoshihiko Yano, Masaru Yoshida, Hiromu Kutsumi, Takanobu Hayakumo, Takeshi Azuma, Division of Gastroenterology, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe, Hyogo 650-0017, Japan.
authors.forename: Midori
authors.initials: M
authors.lastname: Hirai
authors.affiliation: Fumiaki Kawara, Tsuyoshi Fujita, Yoshinori Morita, Atsuhiro Masuda, Masaya Saito, Makoto Ooi, Tsukasa Ishida, Yasuyuki Kondo, Shiei Yoshida, Tatsuya Okuno, Yoshihiko Yano, Masaru Yoshida, Hiromu Kutsumi, Takanobu Hayakumo, Takeshi Azuma, Division of Gastroenterology, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe, Hyogo 650-0017, Japan.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Azuma
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D054458:Amplified Fragment Length Polymorphism Analysis; D065731:Cytochrome P-450 CYP2C19 / Q000235:genetics* / Q000378:metabolism; D004942:Esophagitis, Peptic / Q000175:diagnosis / Q000188:drug therapy* / Q000235:genetics; D005260:Female; D005764:Gastroesophageal Reflux / Q000175:diagnosis / Q000188:drug therapy* / Q000235:genetics; D006801:Humans; D060046:Maintenance Chemotherapy; D008297:Male; D008875:Middle Aged; D012150:Polymorphism, Restriction Fragment Length; D054328:Proton Pump Inhibitors / Q000378:metabolism / 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; C045793:CYP2C19 protein, human; D065731:Cytochrome P-450 CYP2C19
keywords: CYP2C19; FSSG; Gastroesophageal reflux disease; Proton pump inhibitor; Residual symptoms