Predictive Factors of Response to Proton Pump Inhibitors in Korean Patients With Gastroesophageal Reflux Disease.
- Author:
Sung Eun KIM
1
;
Nayoung KIM
;
Sooyeon OH
;
Hee Man KIM
;
Moo In PARK
;
Dong Ho LEE
;
Hyun Chae JUNG
Author Information
- Publication Type:Original Article
- Keywords: Esophagitis; Gastroesophageal reflux; Proton pump inhibitors; Psychology; Sleep disorders
- MeSH: Anxiety; Body Mass Index; Demography; Depression; Esophagitis; Gastroesophageal Reflux*; Gastroscopy; Humans; Hydrogen-Ion Concentration; Multivariate Analysis; Prospective Studies; Proton Pump Inhibitors*; Psychology; Psychotherapy; Quality of Life; Surveys and Questionnaires; Sleep Wake Disorders; World Health Organization
- From:Journal of Neurogastroenterology and Motility 2015;21(1):69-77
- CountryRepublic of Korea
- Language:English
- Abstract: BACKGROUND/AIMS: Proton pump inhibitors (PPIs) are widely used in the treatment of gastroesophageal reflux disease (GERD). However, some patients fail to respond to PPI therapy. We investigated the efficacy of response to PPI therapy in patients with GERD symptoms. METHODS: A total of 179 subjects with GERD symptoms were prospectively enrolled and diagnosed with non-erosive reflux disease (NERD, n = 100) and erosive reflux disease (n = 79) by gastroscopy and Bernstein test and/or 24-hour esophageal pH testing. Subjects then received a standard dose of daily PPI therapy for at least 4 weeks. PPI therapy response was evaluated using questionnaires including questions about demographics, GERD symptoms, GERD impact scale, Epworth sleepiness scale, Pittsburgh sleep quality index (PSQI), hospital anxiety and depression scale, and abbreviated version of the World Health Organization quality of life scale. RESULTS: The rates of complete (> or = 80%), satisfactory (> or = 50%), partial (< 50%), and refractory response in the 179 participants were 41.3%, 30.2%, 18.4%, and 10.1%, respectively. Thus, overall response rate (complete and satisfactory responses) was 71.5%. Multivariate analysis showed body mass index < 23 kg/m2 (OR, 2.20; 95% CI, 1.12-4.34), higher total PSQI score (OR, 1.20; 95% CI, 1.05-1.35), history of psychotherapy or neuropsychiatric medication (OR, 2.44; 95% CI, 1.23-4.85), and NERD (OR, 3.30; 95% CI, 1.54-7.11) were associated with poor response to PPI therapy. CONCLUSIONS: Psychological factors, sleep dysfunction, body mass index < 23 kg/m2, and NERD seem to be the major factors that lead to a poor response to PPI treatment in patients with GERD symptoms.
