Korean J Gastroenterol.  2016 Jul;68(1):16-22. 10.4166/kjg.2016.68.1.16.

The Prevalence and Clinical Features of Non-responsive Gastroesophageal Reflux Disease to Practical Proton Pump Inhibitor Dose in Korea: A Multicenter Study

• Park HJ
• Park SH
• Shim KN
• Kim YS
• Kim HJ
• Han JP
• Kim YS
• Bang BW
• Kim GH
• Baik GH
• Kim HH
• Park SY
• Kim SS

• KMID: 2344487
• DOI: http://doi.org/10.4166/kjg.2016.68.1.16

Abstract

BACKGROUND/AIMS
In Korea, there are no available multicenter data concerning the prevalence of or diagnostic approaches for non-responsive gastroesophageal reflux disease (GERD) which does not respond to practical dose of proton pump inhibitor (PPI) in Korea. The purpose of this study is to evaluate the prevalence and the symptom pattern of non-responsive GERD.
METHODS
A total of 12 hospitals who were members of a Korean GERD research group joined this study. We used the composite score (CS) as a reflux symptom scale which is a standardized questionnaire based on the frequency and severity of typical symptoms of GERD. We defined "non-responsive GERD" as follows: a subject with the erosive reflux disease (ERD) whose CS was not decreased by at least 50% after standard-dose PPIs for 8 weeks or a subject with non-erosive reflux disease (NERD) whose CS was not decreased by at least 50% after half-dose PPIs for 4 weeks.
RESULTS
A total of 234 subjects were analyzed. Among them, 87 and 147 were confirmed to have ERD and NERD, respectively. The prevalence of non-responsive GERD was 26.9% (63/234). The rates of non-responsive GERD were not different between the ERD and NERD groups (25.3% vs. 27.9%, respectively, p=0.664). There were no differences between the non-responsive GERD and responsive GERD groups for sex (p=0.659), age (p=0.134), or BMI (p=0.209). However, the initial CS for epigastric pain and fullness were higher in the non-responsive GERD group (p=0.044, p=0.014, respectively).
CONCLUSIONS
In conclusion, this multicenter Korean study showed that the rate of non-responsive GERD was substantially high up to 26%. In addition, the patients with the non-responsive GERD frequently showed dyspeptic symptoms such as epigastric pain and fullness.

Keyword

Gastroesophageal reflux; Reflux esophagitis; Heartburn; Proton pump inhibitors; Gastric acid

MeSH Terms

Esophagitis, Peptic
Gastric Acid
Gastroesophageal Reflux*
Heartburn
Humans
Korea*
Prevalence*
Proton Pump Inhibitors
Proton Pumps*
Protons*
Proton Pump Inhibitors
Proton Pumps
Protons

Figure

• 

  Fig. 1. Diagram of study process. GERD, gastroesophgeal reflux disease; ERD, erosive reflux disease; NERD, non-erosive reflux disease; F/U, follow up.

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  Fig. 2. Composite scores between intractable gastroesophgeal reflux disease (GERD) and non-intractable GERD. (A) Initial score. (B) Final score.

Reference

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