Persistent gastro-oesophageal reflux symptoms despite proton pump inhibitor therapy.

Author: Daphne ANG ¹ ; Choon How HOW ² ; Tiing Leong ANG ¹
Author Information

1. Department of Gastroenterology and Hepatology, Changi General Hospital, Singapore.
2. Care and Health Integration, Changi General Hospital, Singapore.
Publication Type:Journal Article
Keywords: GERD; acid reflux; non-acid reflux; pH-impedance; reflux hypersensitivity
MeSH: Chest Pain; etiology; Esophagus; drug effects; Gastroenterology; methods; Gastroesophageal Reflux; diagnosis; drug therapy; Heartburn; diagnosis; drug therapy; Humans; Hydrogen-Ion Concentration; Life Style; Primary Health Care; Proton Pump Inhibitors; therapeutic use; Surveys and Questionnaires
From:Singapore medical journal 2016;57(10):546-551
CountrySingapore
Language:English
Abstract: About one-third of patients with suspected gastro-oesophageal reflux disease (GERD) do not respond symptomatically to proton pump inhibitors (PPIs). Many of these patients do not suffer from GERD, but may have underlying functional heartburn or atypical chest pain. Other causes of failure to respond to PPIs include inadequate acid suppression, non-acid reflux, oesophageal hypersensitivity, oesophageal dysmotility and psychological comorbidities. Functional oesophageal tests can exclude cardiac and structural causes, as well as help to confi rm or exclude GERD. The use of PPIs should only be continued in the presence of acid reflux or oesophageal hypersensitivity for acid reflux-related events that is proven on functional oesophageal tests.