Patients with Functional Dyspepsia Responding to Omeprazole Have a Characteristic Gastro-oesophageal Reflux Pattern

Farup, Per G.; Hovde, Øistein; Torp, Roald; Wetterhus, S

doi:10.1080/003655299750026029

Cited by 51 publications

(2 citation statements)

References 19 publications

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“…Various pathophysiological mechanisms in the esophagus, stomach and duodenum might induce dyspeptic symptoms. Acid reflux into the esophagus might cause dyspepsia without reflux symptoms in some patients, which is effectively treated with acid-secretion inhibitors 12. Acid in the stomach might also provoke symptoms.…”

Section: Introductionmentioning

confidence: 99%

The Therapeutic and Diagnostic Value of 2-week High Dose Proton Pump Inhibitor Treatment in Overlapping Non-erosive Gastroesophageal Reflux Disease and Functional Dyspepsia Patients

Kriengkirakul¹,

Patcharatrakul²,

Gonlachanvit³

2012

J Neurogastroenterol Motil

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Background/AimsTo evaluate the value of a 2-week high dose proton pump inhibitor (PPI) treatment on patients with overlapping non-erosive gastroesophageal reflux disease (NERD) and functional dyspepsia (FD).MethodsSixty overlapping NERD and FD patients with symptom onset > 3 months prior underwent 24-hour esophageal pH monitoring studies. All patients received rabeprazole 20 mg b.i.d. for 2 weeks. The reflux and dyspeptic symptoms were evaluated using a symptom questionnaire with 4-point Likert scales before and at the end of treatment. A positive PPI test was defined as score improvement in ≥ 50% from the baseline in the typical reflux symptoms.ResultsThe prevalence of each reflux and dyspeptic symptom did not differ significantly between patients with positive and negative pH tests. After the PPI treatment, epigastric burning, acid regurgitation, heartburn, nausea, vomiting and chest discomfort scores were significantly improved compared to pretreatment values (P < 0.05), whereas postprandial abdominal fullness, early satiation, belching and food regurgitation were not. The proportion of patients who responded to the PPI treatment did not differ significantly between patients with positive and negative pH tests. The sensitivity, specificity, PPV, NPV and accuracy of 2-week high dose rabeprazole treatment for diagnosing gastroesophageal reflux disease were 47%, 38%, 50%, 35% and 43%, respectively.ConclusionsThe two-week high dose PPI treatment was not effective for early satiation, postprandial abdominal fullness, regurgitation or belching symptoms in patients with overlapping NERD and FD. Acid exposure in the distal esophagus could not predict the response of symptoms to PPI. In addition, the 2-week PPI test provided limited value for gastroesophageal reflux disease diagnosis in patients with overlapping NERD and FD.

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Section: Introductionmentioning

confidence: 99%

The Therapeutic and Diagnostic Value of 2-week High Dose Proton Pump Inhibitor Treatment in Overlapping Non-erosive Gastroesophageal Reflux Disease and Functional Dyspepsia Patients

Kriengkirakul¹,

Patcharatrakul²,

Gonlachanvit³

2012

J Neurogastroenterol Motil

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“…The definition of regurgitation remains variable and, to some extent, controversial with the result that it is, generally, heartburn that is considered when reporting the effect of treatment on symptoms. However, despite the reliance on heartburn as the major symptomatic outcome in most clinical trials, it is well recognized that other symptoms, such as epigastric pain, can be major symptoms of GERD [1] associated with excessive esophageal acid exposure and with a good response to acid-suppressive therapy [13, 14]. …”

Section: Diagnosis Of Gerdmentioning

confidence: 99%

A Critical Assessment of the Current Status of Non-Erosive Reflux Disease

Armstrong

2008

Digestion

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Non-erosive reflux disease (NERD) has assumed increasing prominence in studies of gastroesophageal reflux disease (GERD), but it remains a challenge to define NERD precisely and to define its place in the investigation and treatment of GERD. Most simply, NERD may be defined as GERD in an individual who has no evidence of erosions at endoscopy. Unfortunately, the characteristic symptoms of GERD – heartburn and regurgitation – are insufficient to identify all GERD patients and, hence, the diagnosis of NERD is hampered by the lack of clear criteria for the symptomatic diagnosis of GERD. The diagnosis of NERD is hampered further by limited interobserver agreement on the endoscopic diagnosis of erosive esophagitis and by the fact that endoscopy is often performed soon after patients have discontinued therapy. Improvements in endoscopic technology will increase the likelihood of identifying small erosions or other reflux-related lesions; however, this will increase the proportion of patients considered to have erosive esophagitis without defining precisely what constitutes NERD. It is important to recognize that NERD is but one manifestation of GERD and that it, like other manifestations of GERD, is associated with a marked diminution in patients’ quality of life. However, this recognition apart, there seems to be little practical benefit or understanding to be gained in clinical practice or clinical research from considering NERD as a distinct entity or from studying NERD patients in isolation. Advances in understanding the pathogenesis of GERD and its symptoms may be better served by categorizing GERD with respect to the spectrum of its histologic, functional, endoscopic and symptomatic manifestations rather than by studying NERD, a manifestation that is characterized solely by the absence of esophageal erosions.

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Pharmacological interventions for non-ulcer dyspepsia

Martin¹,

Soo²,

Deeks³

et al. 2005

Cochrane Database of Systematic Reviews

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Patients with Functional Dyspepsia Responding to Omeprazole Have a Characteristic Gastro-oesophageal Reflux Pattern

Abstract: Patients with FD responding to omeprazole were characterized by many reflux episodes.

Cited by 51 publications

References 19 publications

The Therapeutic and Diagnostic Value of 2-week High Dose Proton Pump Inhibitor Treatment in Overlapping Non-erosive Gastroesophageal Reflux Disease and Functional Dyspepsia Patients

The Therapeutic and Diagnostic Value of 2-week High Dose Proton Pump Inhibitor Treatment in Overlapping Non-erosive Gastroesophageal Reflux Disease and Functional Dyspepsia Patients

A Critical Assessment of the Current Status of Non-Erosive Reflux Disease

Pharmacological interventions for non-ulcer dyspepsia

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