Patients with refractory reflux symptoms often do not have GERD

  • Herregods T
  • Troelstra M
  • Weijenborg P
 et al. 
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Abstract

Background: In patients with typical reflux symptoms that persist despite proton pump inhibitors (PPIs) it is sometimes overlooked that treatment fails due to the presence of other disorders than gastroesophageal reflux disease (GERD). The aim of this study was to determine the underlying cause of reflux symptoms not responding to PPI therapy in tertiary referral patients. Methods: Patients with reflux symptoms refractory to PPI therapy who underwent 24-h pH-impedance monitoring were analyzed. Patients in whom a diagnosis was already established before referral, who had previous esophageal or gastric surgery, or who had abnormalities on gastroscopy other than hiatus hernia, were excluded. Key Results: In total, 106 patients were included. Esophageal manometry showed achalasia in two patients and distal esophageal spasm in another two. Twenty-four-hour pH-impedance monitoring revealed a total acid exposure time

Author-supplied keywords

  • Functional heartburn
  • PPI
  • Refractory reflux symptoms
  • Treatment failure
  • Unresponsive

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