Abstract | OBJECTIVES: Data supporting the use of the proton pump inhibitor (PPI) test as a diagnostic test of gastroesophageal reflux disease ( GERD) in Asia are lacking. The aims of this study were to evaluate the diagnostic characteristics of the PPI test and factors associated with responsiveness to PPIs. METHODS: The PPI test was evaluated using lansoprazole (30 mg bid) for two weeks. All patients underwent endoscopy after symptom assessment. Patients without erosive esophagitis (ERD) underwent 48 h esophageal Bravo pH monitoring. Subjects were considered to be responsive to PPIs if they reported a > 50% reduction in reflux symptom score. RESULTS: Seventy-three patients (M:F = 40:37, 47 +/- 13 years) were enrolled. We identified 46 patients with ERD, 18 patients with nonerosive reflux disease (NERD) and 9 patients without GERD. The PPI response rate was higher in patients with GERD than in patients without GERD (49/64, 77% vs. 4/9, 44%; p < 0.05). The sensitivity, specificity, and positive and negative predictive values were 77%, 56%, 92% and 25%, respectively. The PPI responsiveness was 80% (37/46) in the ERD group and 67% (12/18) in the NERD group. PPI response was not affected by age, sex, Helicobacter pylori, the psychological characteristics or cytochrome P2C genotypes. ERD and symptom-reflux association were the factors affecting PPI responsiveness. CONCLUSIONS: The PPI test was modestly sensitive and specific for diagnosing GERD. However, it would be useful for discriminating patients with ERD. In the NERD group, patients with positive symptom-reflux association would be most benefit from PPI treatment.
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Authors | Yu Kyung Cho, Myung-Gyu Choi, Chul Hyun Lim, Kwan Woo Nam, Jae Hyuck Chang, Jae Myung Park, In Seok Lee, Sang Woo Kim, Kyu Yong Choi, In-Sik Chung |
Journal | Scandinavian journal of gastroenterology
(Scand J Gastroenterol)
Vol. 45
Issue 5
Pg. 533-9
(May 2010)
ISSN: 1502-7708 [Electronic] England |
PMID | 20180645
(Publication Type: Clinical Trial, Journal Article)
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Chemical References |
- 2-Pyridinylmethylsulfinylbenzimidazoles
- Proton Pump Inhibitors
- Lansoprazole
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Topics |
- 2-Pyridinylmethylsulfinylbenzimidazoles
- Chi-Square Distribution
- Esophageal pH Monitoring
- Esophagoscopy
- Female
- Gastroesophageal Reflux
(diagnosis)
- Humans
- Korea
- Lansoprazole
- Male
- Middle Aged
- Polymerase Chain Reaction
- Polymorphism, Restriction Fragment Length
- Predictive Value of Tests
- Prospective Studies
- Proton Pump Inhibitors
- Psychiatric Status Rating Scales
- Quality of Life
- Sensitivity and Specificity
- Statistics, Nonparametric
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