Acid and non-acid reflux in patients refractory to proton pump inhibitor therapy: Is gastroparesis a factor?

Anna Tavakkoli, Bisma A. Sayed, Nicholas J. Talley, Baharak Moshiree

Research output: Contribution to journalArticle

8 Scopus citations

Abstract

Aim: To determine whether an increased number and duration of non-acid reflux events as measured using the multichannel intraluminal impedance pH (MII-pH) is linked to gastroparesis (GP). Methods: A case control study was conducted in which 42 patients undergoing clinical evaluation for continued symptoms of gastroesophageal reflux disease (both typical and atypical symptoms) despite acid suppression therapy. MII-pH technology was used over 24 h to detect reflux episodes and record patients' symptoms. Parameters evaluated in patients with documented GP and controls without GP by scintigraphy included total, upright, and supine number of acid and non-acid reflux episodes (pH < 4 and pH > 4, respectively), the duration of acid and non-acid reflux in a 24-h period, and the number of reflux episodes lasting longer than 5 min. Results: No statistical difference was seen between the patients with GP and controls with respect to the total number or duration of acid reflux events, total number and duration of non-acid reflux events or the duration of longest reflux episodes. The number of nonacid reflux episodes with a pH > 7 was higher in subjects with GP than in controls. In addition, acid reflux episodes were more prolonged (lasting longer than 5 min) in the GP patients than in controls; however, these values did not reach statistical significance. Thirty-five patients had recorded symptoms during the 24 h study and of the 35 subjects, only 9% (n = 3) had a positive symptom association probability (SAP) for acid/non-acid reflux and 91% had a negative SAP. Conclusion: The evaluation of patients with a documented history of GP did not show an association between GP and more frequent episodes of non-acid reflux based on MII-pH testing.

Original languageEnglish (US)
Pages (from-to)6193-6198
Number of pages6
JournalWorld Journal of Gastroenterology
Volume19
Issue number37
DOIs
StatePublished - Oct 7 2013

Keywords

  • Acid gastroesophageal reflux
  • Functional bowel disorder
  • Gastroparesis
  • Multi-channel intraluminal impedance
  • Non-acid gastroesophageal reflux

ASJC Scopus subject areas

  • Gastroenterology

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