Pathogenesis of Double-Dose Proton Pump Inhibitor-Resistant Non-Erosive Reflux Disease, and Mechanism of Reflux Symptoms and Gastric Acid Secretion-Suppressive Effect in the Presence or Absence of <b><i>Helicobacter pylori </i></b>Infection

• DOI: 10.1159/000455834
• Publication Date: 2017-02-08T12:59:54Z
• Authors: Noriyuki Kawami; Nana Takenouchi; Mariko Umezawa; Shintaro Hoshino; Yuriko Hanada; Yoshimasa Hoshikawa; Hirohito Sano; Yoshio Hoshihara; Tsutomu Nomura; Eiji Uchida; Katsuhiko Iwakiri
• Keywords: Nerd; Pathogenesis; Reflux esophagitis; Eosinophilic Esophagitis

Various mechanisms have been suggested to be responsible for contributing the occurrence of proton pump inhibitor (PPI)-resistant non-erosive reflux disease (NERD). The aims this study were clarify pathogenesis PPI-resistant NERD.Fifty-three patients with NERD, who had persistent symptoms despite taking double-dose PPI, included in study. After excluding eosinophilic esophagitis (EoE) and primary esophageal motility disorder, impedance-pH monitoring was carried out. In symptom index (SI)-positive patients, mechanism SI positivity percent time intragastric pH >4 investigated according presence or absence Helicobacter pylori infection.One 53 EoE, 4 disorder. Twenty-three 2 SI-positive liquid gas-only respectively. Of 17 SI-positive, H. pylori-negative 5 acid reflux, whereas all pylori-positive non-acid reflux. significantly lower than patients.The NERD identified 57%. some acid-related observed. However, these excluded by PPI.