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Impedance-pH monitoring in proton pump inhibitor resistant patients: ready for clinical application?

Correspondence to:
Correspondence to:
Professor J P Galmiche
Institut des Maladies de l’Appareil Digestif, University Hospital Hôtel-Dieu, 44093 Nantes, France; jeanpaul.galmiche@chu-nantes.fr

Keywords: multichannel intraluminal impedance and pH; gastro-oesophageal reflux disease; non-acid reflux; proton pump inhibitor; symptom analysis

The first 150 words of the full text of this article appear below.

Gastro-oesophageal reflux disease (GORD) is a very common disorder in which the reflux of gastric (or gastroduodenal) contents causes troublesome symptoms and/or lesions of the oesophageal mucosa. The harmful effects of acid injury on the oesophageal mucosa have been established for decades by experimental and clinical studies.¹ From a clinical and therapeutic viewpoint, the central role of acid in the pathogenesis of reflux symptoms and lesions of the oesophagitis was most convincingly confirmed by the introduction of acid suppressive therapy; the development of proton pump inhibitors (PPIs) achieved a level of efficacy not previously reached by antacids or H₂ blockers.²

Despite the progress made with PPIs, it has now however become clear that up to 40% of patients with GORD symptoms are either not completely satisfied with their acid suppressive therapy or may be resistant to PPIs.³ Several reasons may underlie an individual’s resistance to his or her PPI . . . [Full text of this article]

Relevant Article

Acid and non-acid reflux in patients with persistent symptoms despite acid suppressive therapy: a multicentre study using combined ambulatory impedance-pH monitoring

I Mainie, R Tutuian, S Shay, M Vela, X Zhang, D Sifrim, and D O Castell
Gut 2006 55: 1398-1402. [Abstract] [Full Text] [PDF]