Kimio Isshi1,2, Nobuyuki Matsuhashi3, Takashi Joh4, Kazuhide Higuchi5, Katsuhiko Iwakiri6, Takeshi Kamiya7, Noriaki Manabe8, Maiko Ogawa9, Seiji Arihiro9, Ken Haruma10, Koji Nakada11. 1. Isshi Gastro-Intestinal Clinic, 2-15-21, Shinozaki-Cho, Edogawa-ku, Tokyo, 133-0061, Japan. isshi-ki@jikei.ac.jp. 2. Department of Endoscopy, Jikei University School of Medicine, 3-15-8 Nishishinbashi, Minato-Ku, Tokyo, 105-8461, Japan. isshi-ki@jikei.ac.jp. 3. Department of Gastroenterology, NTT Medical Center Tokyo, 5-9-22, Higashi-Gotanda, Shinagawa-Ku, Tokyo, 105-8461, Japan. 4. Gamagori City Hospital, 1-1 Mukaida, Hirata-Cho, Gamagori-City, Aichi, 443-8501, Japan. 5. Second Department of Internal Medicine, Osaka Medical College, 2-7 Daigaku-machi, Takatsuki, Osaka, 569-8686, Japan. 6. Department of Gastroenterology, Nippon Medical School Graduate School of Medicine, 1-1-5, Sendagi, Bunkyo-Ku, Tokyo, 133-8603, Japan. 7. Department of Medical Innovation, Nagoya City University Graduate School Medical Sciences, 1, Kawasumi, Mizuho-Cho, Mizuho-Ku, Nagoya, 467-8601, Japan. 8. Division of Endoscopy and Ultrasonography, Department of Laboratory Medicine, Kawasaki Medical School General Medical Center, 2-6-1, Nakayamashita, Kita-Ku, Okayama-City, Okayama, 700-8505, Japan. 9. Division of Gastroenterology and Hepatology, Department of Internal Medicine, Katsushika Medical Center Jikei University School of Medicine, 6-41-2, Aoto, Katsushika-Ku, Tokyo, 125-8506, Japan. 10. Department of General Internal Medicine 2, Kawasaki Medical School Kawasaki Hospital, 577, Matsushima, Kurashiki, Okayama, 701-0192, Japan. 11. Department of Laboratory Medicine, The Jikei University Daisan Hospital, 4-11-1, Izumihon-Cho, Komae-City, Tokyo, 201-8601, Japan.
Abstract
BACKGROUND AND AIM: Gastroesophageal reflux disease (GERD) and functional dyspepsia (FD) are frequently overlapped. However, no treatment strategies have been established yet for such patients. This study compared the effects of proton pump inhibitor (PPI) treatment in patients with GERD-associated FD among three groups with varying severity levels of GERD symptoms. METHODS: The patients with GERD and FD symptoms received PPI treatment for 4 weeks after endoscopy, and the severity of the symptoms and responses to treatment were evaluated at before and after 4 weeks of treatment using the Gastroesophageal Reflux and Dyspepsia Therapeutic Efficacy and Satisfaction Test (GERD-TEST). The patients were divided into three groups in accordance with the severity of the GERD symptoms as assessed by the GERD symptom subscale (SS) scores of pre-treatment. RESULTS: Data from 233 cases of 40 mild, 151 moderate and 42 severe symptoms were analyzed. Analysis of the pre-treatment scores for each symptom revealed that a higher GERD-SS score was significantly associated with higher scores on any kind of FD score. Four weeks of PPI treatment significantly and markedly alleviated any of GERD/FD symptoms. Most importantly, change in the score for each symptom after 4 weeks of treatment relative to the pre-treatment score was significantly greater in the groups with more severe GERD-SS. CONCLUSION: FD symptoms associated with more severe GERD symptoms are supposed to be acid-related dyspepsia, and PPI monotherapy is recommended as the treatment of first choice in such patients.
BACKGROUND AND AIM: Gastroesophageal reflux disease (GERD) and functional dyspepsia (FD) are frequently overlapped. However, no treatment strategies have been established yet for such patients. This study compared the effects of proton pump inhibitor (PPI) treatment in patients with GERD-associated FD among three groups with varying severity levels of GERD symptoms. METHODS: The patients with GERD and FD symptoms received PPI treatment for 4 weeks after endoscopy, and the severity of the symptoms and responses to treatment were evaluated at before and after 4 weeks of treatment using the Gastroesophageal Reflux and Dyspepsia Therapeutic Efficacy and Satisfaction Test (GERD-TEST). The patients were divided into three groups in accordance with the severity of the GERD symptoms as assessed by the GERD symptom subscale (SS) scores of pre-treatment. RESULTS: Data from 233 cases of 40 mild, 151 moderate and 42 severe symptoms were analyzed. Analysis of the pre-treatment scores for each symptom revealed that a higher GERD-SS score was significantly associated with higher scores on any kind of FD score. Four weeks of PPI treatment significantly and markedly alleviated any of GERD/FD symptoms. Most importantly, change in the score for each symptom after 4 weeks of treatment relative to the pre-treatment score was significantly greater in the groups with more severe GERD-SS. CONCLUSION:FD symptoms associated with more severe GERD symptoms are supposed to be acid-related dyspepsia, and PPI monotherapy is recommended as the treatment of first choice in such patients.
Authors: H Miwa; K Nakajima; K Yamaguchi; K Fujimoto; S J O Veldhuyzen VAN Zanten; Y Kinoshita; K Adachi; H Kusunoki; K Haruma Journal: Aliment Pharmacol Ther Date: 2007-07-15 Impact factor: 8.171
Authors: Durk R De Vries; Margot A Van Herwaarden; Astrid Baron; André J P M Smout; Melvin Samsom Journal: Scand J Gastroenterol Date: 2007-08 Impact factor: 2.423