{"title":"Clinical Value of the Symptom-Reflux Association on Secondary Treatment Outcomes in Patients with Abnormal Acid Reflux.","authors":"Satsuki Takahashi, Tomoaki Matsumura, Michiko Sonoda, Tomomi Ozaki, Tatsuya Kaneko, Ryosuke Horio, Chihiro Goto, Akane Kurosugi, Yuki Ohta, Takashi Taida, Atsuko Kikuchi, Kenichiro Okimoto, Jun Kato","doi":"10.1159/000547213","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>Multichannel intraluminal impedance and pH monitoring (MII-pH) is the gold standard for diagnosing gastroesophageal reflux disease (GERD). However, the clinical value of the symptom-reflux association (SRA) obtained using MII-pH remains unknown. The current study aimed to investigate the effect of SRA on the efficacy of secondary treatment in refractory true GERD.</p><p><strong>Methods: </strong>This study included patients who underwent MII-pH monitoring for evaluating proton pump inhibitor (PPI)- or potassium-competitive acid blocker (P-CAB)-refractory GERD symptoms and who were diagnosed with abnormal acid reflux (acid exposure time >6%). Patients with a positive symptom index (SI) and symptom association probability on the MII-pH monitoring were included in the SRA-positive group and the remaining ones in the SRA-negative group. The differences in the subsequent treatment efficacy between the two groups were retrospectively analyzed. Treatment efficacy was evaluated using the Frequency Scale for the Symptoms of GERD (FSSG) questionnaire.</p><p><strong>Results: </strong>Of the 192 patients with PPI-/P-CAB-refractory GERD, 41 (21.4%) were diagnosed with abnormal acid reflux. Among them, 30 (7 in the SRA-positive group and 23 in the SRA-negative group) underwent symptom assessments before and after treatment. The SRA-positive group had a significantly greater symptom improvement after treatment compared with the SRA-negative group (FSSG score changes: -13.0 ± 6.5 vs. -5.4 ± 8.2, p = 0.016).</p><p><strong>Conclusions: </strong>SRA evaluation is effective in predicting secondary treatment outcomes in patients with abnormal acid reflux.</p>","PeriodicalId":11315,"journal":{"name":"Digestion","volume":" ","pages":"1-10"},"PeriodicalIF":3.6000,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Digestion","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1159/000547213","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"GASTROENTEROLOGY & HEPATOLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Introduction: Multichannel intraluminal impedance and pH monitoring (MII-pH) is the gold standard for diagnosing gastroesophageal reflux disease (GERD). However, the clinical value of the symptom-reflux association (SRA) obtained using MII-pH remains unknown. The current study aimed to investigate the effect of SRA on the efficacy of secondary treatment in refractory true GERD.
Methods: This study included patients who underwent MII-pH monitoring for evaluating proton pump inhibitor (PPI)- or potassium-competitive acid blocker (P-CAB)-refractory GERD symptoms and who were diagnosed with abnormal acid reflux (acid exposure time >6%). Patients with a positive symptom index (SI) and symptom association probability on the MII-pH monitoring were included in the SRA-positive group and the remaining ones in the SRA-negative group. The differences in the subsequent treatment efficacy between the two groups were retrospectively analyzed. Treatment efficacy was evaluated using the Frequency Scale for the Symptoms of GERD (FSSG) questionnaire.
Results: Of the 192 patients with PPI-/P-CAB-refractory GERD, 41 (21.4%) were diagnosed with abnormal acid reflux. Among them, 30 (7 in the SRA-positive group and 23 in the SRA-negative group) underwent symptom assessments before and after treatment. The SRA-positive group had a significantly greater symptom improvement after treatment compared with the SRA-negative group (FSSG score changes: -13.0 ± 6.5 vs. -5.4 ± 8.2, p = 0.016).
Conclusions: SRA evaluation is effective in predicting secondary treatment outcomes in patients with abnormal acid reflux.
期刊介绍:
''Digestion'' concentrates on clinical research reports: in addition to editorials and reviews, the journal features sections on Stomach/Esophagus, Bowel, Neuro-Gastroenterology, Liver/Bile, Pancreas, Metabolism/Nutrition and Gastrointestinal Oncology. Papers cover physiology in humans, metabolic studies and clinical work on the etiology, diagnosis, and therapy of human diseases. It is thus especially cut out for gastroenterologists employed in hospitals and outpatient units. Moreover, the journal''s coverage of studies on the metabolism and effects of therapeutic drugs carries considerable value for clinicians and investigators beyond the immediate field of gastroenterology.