Water load test before and after PPI therapy in patients with gastro-oesophageal reflux disease.

Abstract

BACKGROUND:

Patients with gastro-oesophageal reflux disease may complain of epigastric pain, bloating, early satiety, epigastric fullness, epigastric burning, nausea and vomiting.

AIMS:

To evaluate the symptoms in response to gastric distension and its relationship to a therapeutic course in patients with gastro-oesophageal reflux disease using the water load test, compared to healthy controls.

METHODS:

Thirty gastro-oesophageal reflux disease patients with grade A oesophagitis (studied before and after 4 weeks of therapy with esomeprazole, 40 mg per day) and 15 patients with reflux-related symptoms demonstrated at wireless pH monitoring (non-erosive reflux disease) were compared to 30 healthy volunteers.

RESULTS:

Patients with grade A oesophagitis and with reflux-related symptoms ingested significantly lower water volumes than did controls, before onset of fullness, without statistically significant difference between erosive or non-erosive gastro-oesophageal reflux disease; this variable improved in patients after treatment. Nausea scores were higher basally in patients, pre- and post-therapy, and improved after therapy. Thirty-minute fullness and bloating scores improved after therapy in all gastro-oesophageal reflux disease patients compared to controls and pre-therapy. In all pre-treatment patients, a significant correlation was found only with epigastric fullness; after treatment, there was no significant relationship between the water load and the symptom scores.

CONCLUSIONS:

In patients with reflux-related symptoms, with or without grade A oesophagitis, the water load test is frequently abnormal, suggesting an altered gastric function. This could explain the incomplete resolution of symptoms after treatment in some patients, and should lead to additional studies aimed at exploring gastric function in gastro-oesophageal reflux disease patients.

• Authors: E Battaglia, M Grassini, M Navino, P Niola, C Verna, A Mazzocchi, C Clerici, A Morelli, G Bassotti
• Journal: Digestive and liver disease : official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver (Dig Liver Dis) Vol. 39 Issue 12 Pg. 1052-6 (Dec 2007) ISSN: 1590-8658 [Print] Netherlands
• PMID: 17913607 (Publication Type: Journal Article)

Chemical References

• Enzyme Inhibitors
• Water
• Esomeprazole

Topics

• Adult
• Drinking (physiology)
• Dyspepsia (drug therapy, etiology)
• Enzyme Inhibitors (therapeutic use)
• Esomeprazole (therapeutic use)
• Esophagitis, Peptic (complications, diagnosis, drug therapy)
• Female
• Gastroesophageal Reflux (complications, diagnosis, drug therapy)
• Humans
• Male
• Middle Aged
• Treatment Outcome
• Water