• Profile

Psychosocial distress and quality of life impairment are associated with symptom severity in PPI non-responders with normal impedance-pH profiles

The American Journal of Gastroenterology Sep 15, 2017

Yadlapati R, et al. - The clinicians identified factors correlated with symptom perception among proton pump inhibitor (PPI) non-responder phenotypes. Among PPI non-responders with normal impedance-pH, perceptions of reflux symptoms were associated with psychosocial distress, reduced quality of life (QOL), and sensation of dysphagia. Patient-reported symptom severity was correlated with physiological differences among PPI refractory gastroesophageal reflux disease (GERD) patients, as opposed to psychosocial factors.

  • From September 2014 to January 2017, the clinicians performed this prospective observational cohort study at a single academic medical center.
  • They included PPI non-responders who underwent 24-h impedance-pH monitoring and completed a questionnaire set measuring patient-reported symptom severity, quality of life (QOL), and psychosocial distress.
  • Based on impedance-pH results, participants were separated into cohorts:
    • On PPI: -acid exposure time (AET)/-symptom–reflux association (SRA), +AET, and -AET/+SRA
    • Off PPI: functional (-AET/-SRA), gastroesophageal reflux disease (GERD) (+AET), and reflux hypersensitivity (RHS) (-AET/+SRA).
  • Abnormal GERD symptom severity defined by GerdQ≥8 was the primary outcome.

  • The clinicians included 192 participants.
  • They performed impedance-pH on PPI on 125: 72 (58%) -AET/-SRA, 42 (34%) +AET, and 11 (9%) -AET/+SRA.
  • Factors associated with GerdQ≥8 among the -AET/-SRA group were younger age, higher dysphagia scores, QOL impairment, and higher brief symptom index.
  • Higher number of reflux-associated symptoms and lower distal contractile integral was associated with GerdQ≥8 among the +AET group.
  • They performed impedance-pH off PPI on 67 participants: 39 (58%) functional, 16 (24%) GERD, and 12 (18%) RHS.
  • Higher QOL impairment and dysphagia scores were seen with GerdQ≥8 among the functional group.
Go to Original
Only Doctors with an M3 India account can read this article. Sign up for free or login with your existing account.
4 reasons why Doctors love M3 India
  • Exclusive Write-ups & Webinars by KOLs

  • Nonloggedininfinity icon
    Daily Quiz by specialty
  • Nonloggedinlock icon
    Paid Market Research Surveys
  • Case discussions, News & Journals' summaries
Sign-up / Log In
M3 app logo
Choose easy access to M3 India from your mobile!

M3 instruc arrow
Add M3 India to your Home screen
Tap  Chrome menu  and select "Add to Home screen" to pin the M3 India App to your Home screen