Efficacy and safety of omeprazole in Japanese patients with nonerosive reflux disease

Uemura, Naomi; Inokuchi, Hideto; Shinmoto, Hiroshi; Chikama, Toshiharu; Yamauchi, Masao; Tsuru, T.; Umezu, Toru; T, Urata; Yurino, Nobuo; Tanabe, Satoshi; Yoshida, Tomoharu; Kawamura, Susumu; Murakami, Atsushi; Yamamoto, Munemitsu; Chiba, Tsutomu

doi:10.1007/s00535-008-2214-5

Cited by 36 publications

(39 citation statements)

References 24 publications

(29 reference statements)

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“…There were, however, no differences in measures of QOL or depression and anxiety between the two treatment groups. Studies of PPI therapy in predominantly Caucasian, Western patients with NERD have found a complete symptom resolution rate of 29.3-59%, and a satisfactory symptom resolution rate of 56.7-73% [13,[15][16][17]; similarly, studies in the Japanese population found complete response rates of between 25.8 and 44% [18,19]. Our rate of complete symptom resolution was 24.4% and the rate of satisfactory symptom resolution was 57.1%.…”

Section: Discussionsupporting

confidence: 50%

Treatment of non-erosive reflux disease with a proton pump inhibitor in Chinese patients: a randomized controlled trial

et al. 2011

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Section: Discussionsupporting

confidence: 50%

Treatment of non-erosive reflux disease with a proton pump inhibitor in Chinese patients: a randomized controlled trial

et al. 2011

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“…NERD accounts for at least half of GERD cases [3], but acid reflux has little role in the pathogenic mechanism [4], and with proton pump inhibitors (PPIs), which are the first choice of treatment in GERD [5,6], the symptom improvement rate in NERD is low [3,7,8,9]. In the pathogenesis of PPI-refractory NERD, which occurs in ≥50% of NERD patients, other than acidity, nonacid reflux, abnormal esophageal motility, esophageal hypersensitivity and psychological factors are intricately related [10].…”

Section: Introductionmentioning

confidence: 99%

The Role of Gastroesophageal Reflux in Relation to Symptom Onset in Patients with Proton Pump Inhibitor-Refractory Nonerosive Reflux Disease Accompanied by an Underlying Esophageal Motor Disorder

Izawa

Funaki²,

Iida³

et al. 2014

Digestion

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Background: The symptom improvement rate is low with proton pump inhibitors (PPIs) in nonerosive reflux disease (NERD). The underlying pathogenic mechanism is complex. Esophageal motility disorders (EMDs) are thought to be a factor, but their prevalence, type, symptoms and the role played by gastroesophageal reflux (GER) in symptom onset have not been fully investigated. Aim: To investigate the role of GER in symptom onset in PPI-refractory NERD patients with EMDs. Methods: This study comprised 76 patients withPPI-refractory NERD. Manometry was performed during PPI treatment and patients were divided into an EMD group and normal motility (non-EMD) group. Then, multichannel intraluminal impedance-pH monitoring was performed and medical interviews were conducted. Results: Nineteen patients (25%) had an EMD. Data were compared between 17 patients, excluding 2 with achalasia and 57 non-EMD patients. No significant differences were observed between groups in 24-hour intraesophageal pH <4 holding time (HT), mean number of GER episodes or mean number of proximal reflux episodes. The reflux-related symptom index (≥50%) showed a relationship between reflux and symptoms in 70.5% of EMD patients and 75% of non-EMD patients. In the EMD group, the score for FSSG (Frequency Scale for the Symptoms of GERD) question (Q)10 was significantly correlated with the number of GER episodes (r = 0.58, p = 0.02) and the number of proximal reflux episodes (r = 0.63, p = 0.02). In addition, the score for Q9 tended to be correlated with the number of GER episodes (r = 0.44, p = 0.06). Conclusion: Our results suggest that some PPI-refractory NERD patients have EMDs, and that GER plays a role in symptom onset.

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“…In the meta-analysis of 17 randomized controlled trials in which reflux patients were included and PPI was compared with the arms of surgery or placebo, no difference was observed in terms of all of the adverse effects (RR: 1.04, 95% CI: 0.98-1.11) (23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34)(35)(36)(37)(38)(39). In the meta-analysis of 6 randomized trials in which H2RA and placebo were compared, the incidence of all of the adverse effects was similar among the arms (RR: 1.13, 95% CI: 0.97-1.31) (39)(40)(41)(42)(43)(44).…”

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confidence: 99%

What is the long term acid inhibitor treatment in gastroesophageal reflux disease? What are the potential problems related to long term acid inhibitor treatment in gastroesophageal reflux disease? How should these cases be followed?

Hatemı

Esatoğlu

2017

Turk J Gastroenterol

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Decreased acid secretion is thought to adversely affect the absorption of calcium and increase the risk of fracture by causing a decrease in bone density. The meta-analyses of observational studies conducted with heterogeneous populations showed that the risk of any fracture (OR: 1.29, 95% CI: 1.18-1.41) and hip fracture (OR: 1.23, 95% CI: 1.11-1.36) slightly increased with PPI depending on the dose and regardless of duration; but no risk increase was detected with H2RA use (1,2).There are meta-analyses with different methodologies reporting that high gastric pH values developing due to acid inhibition increases Clostridium difficile infections by altering the intestinal microflora and in observational studies conducted with different patient populations. This risk has been reported to be higher in PPI treatment (OR: 2.15, 95% CI: 1.81-2.55) compared to H2RA (OR: 1.44, 95% CI: 1.22-1.70) (3,4).It was reported in the meta-analysis published in 2013 that bacterial overgrowth increased with the use of PPI (OR: 2.26, 95% CI: 1.24-4.2) (5). Spontaneous bacterial peritonitis that develops due to the translocation of enteric pathogens is a significant cause of mortality for cirrhotic patients. The hypothesis that the risk of spontaneous bacterial peritonitis may increase due to easy proliferation of intestinal bacteria with decreased stomach acid has been confirmed in the meta-analysis of observational studies in which the relationship with PPI was investigated (OR: 3.15, 95% CI: 2.09-4.74). On the Turk J Gastroenterol 2017; 28(Suppl 1): S57-S60What is the long term acid inhibitor treatment in gastroesophageal reflux disease? What are the potential problems related to long term acid inhibitor treatment in gastroesophageal reflux disease? How should these cases be followed? S57 ABSTRACTThe meta-analyses of observational studies (OBS) showed the risk of any fracture and hip fracture slightly increased with proton pump inhibitor (PPI) treatment depending on the dose and regardless of time. This was not observed with histamine-2 receptor antagonists (H2RA). The risk of bacterial overgrowth and spontaneous bacterial peritonitis were increased with PPI therapy, but not with H2RA. In meta-analyses of OBS, a slight increase was observed in the risk of community-acquired pneumonia (CAP) in the early stages (<1 month) of PPI use and particularly at high doses. In a five-year LOTUS study, no difference was found in vitamin B12, folic acid, vitamin D, and calcium values in terms of the initial and end of follow-up levels. No increase in the risk of premalignant gastric lesions was observed in the meta-analysis of RCTs in which PPI treatment (≥6 months) was given to Helicobacter pylori negative patients. The risk of hypomagnesemia with PPI use was increased in patients having GFR<60, using diuretics, and over 65 years of age. Quasi-experimental studies showed a reduced zinc absorption with PPI use. In the meta-analysis of OBS, long-term (>1 year) PPI use increased the risk of fundic polyps, but no risk was found in shorter use. Th...

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Efficacy and safety of omeprazole in Japanese patients with nonerosive reflux disease

Abstract: Omeprazole 10 mg or 20 mg once daily is effective and well tolerated in patients with NERD regardless of their endoscopic classification.

Cited by 36 publications

References 24 publications

Treatment of non-erosive reflux disease with a proton pump inhibitor in Chinese patients: a randomized controlled trial

Treatment of non-erosive reflux disease with a proton pump inhibitor in Chinese patients: a randomized controlled trial

The Role of Gastroesophageal Reflux in Relation to Symptom Onset in Patients with Proton Pump Inhibitor-Refractory Nonerosive Reflux Disease Accompanied by an Underlying Esophageal Motor Disorder

What is the long term acid inhibitor treatment in gastroesophageal reflux disease? What are the potential problems related to long term acid inhibitor treatment in gastroesophageal reflux disease? How should these cases be followed?

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