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Results: In a total of 108 patients with RH, 60 patients (55.56%) were the PPI responders, and 48 (44.44%) were the nonresponders. When compared with the nonresponderss, the PPI responders had a lower PSPW index (54.55614.78 vs. 60.56613.00, P50.032) and a decreased value of MNBI (2391MNBI ( .366337.44 vs. 2595. Multivariate logistic regression revealed that only pathologic PSPW index (OR: 2.064) and MNBI (OR: 1.800) exerted a significant influence on PPI response (Table ). Conclusion: Nearly half of RH patients were PPI nonresponders. Pathologic PSPW index and MNBI were independently associated with PPI response in RH patients, highlighting the importance of performing impedance-pH tests.[0406] Figure 1. Flow chart of study participation. (2) Frequency of each RH in the studied population. The majority of patients presented heartburn(69, 63.89%) and chest pain (60, 55.56%); 75 out of the 108 patients (69.44%) presented typical symptoms. RH: Reflux hypersensitivity.(3) The comparison of the pathologic PSPW index, pathologic MNBI, AET between 4-6% with total reflux number .80 between PPI response group and non-response group. There were more patients in PPI response group than non-response group (42 vs. 9, P,0.001) with regard to pathologic PSPW index.

Conclusion: 1) Pyloric EndoFLIP is an important new modality providing real-time data about the effectiveness of PP in medication refractory GP patients. 2) Our EndoFLIP findings indicate a significant improvement of diameter post-PP accompanied by a marked acceleration of GE. 3) There is pathology of the pyloric smooth muscle in GP as shown by a reduction in the number of ICC compared to controls.[1589] Figure 1. Measurements and comparisons of distensibility, diameter, and gastric retention pre and post-pyloroplasty using EndoFLIP

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