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In patients with PPI-unresponsive reflux, functional oesophagal disorders are not only prevalent but also strongly linked with worse psychological and sleep outcomes, underscoring the need for a holistic approach to treatment.
Many patients continue to suffer from reflux symptoms despite proton-pump inhibitor treatment. This interesting research published in the Journal of Gastroenterology and Hepatology explored the prevalence and characteristics of functional oesophagal disorders (FED) in these cases.
They reviewed patients whose reflux symptoms persisted even after ≥8 weeks of PPI therapy. Different evaluates were used, which included- gastroesophageal reflux disease questionnaires, 5-Brief Symptom Rating Scale, Pittsburgh Sleep Quality Index, esophagogastroduodenoscopy, high-resolution impedance manometry, and 24-hour impedance-pH monitoring off PPIs.
Out of 190 patients, 16.8% had non-erosive reflux disease (NERD), while 83.2% had FED, including 57.9% with functional heartburn and 25.3% with reflux hypersensitivity. FED patients had lower body mass indices than NERD patients, more psychological comorbidities, and poorer sleep quality compared to healthy individuals. The severity of reflux symptoms in FED patients correlated with psychological distress and sleep issues.
A remarkable 83.2% of those with PPI-resistant reflux symptoms have functional oesophagal disorders (FED).
Journal of Gastroenterology and Hepatology
Prevalence of functional esophageal disorders and associated clinical characteristics in patients with proton-pump-inhibitor-unresponsive reflux symptoms
Ming-Han Wei et al.
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