Predictors of proton pump inhibitor failure in XXXX : A study with impedance-pH monitoring and high-resolution manometry.

@entity1 @entity1537 @entity354 @entity2210 @entity4423
BACKGROUND: Approximately one-third of @entity354 ( @entity354 ) @entity1 have symptoms resistant to proton pump inhibitor (PPI). We used the high-resolution manometry (HRM) and multichannel intraluminal impedance-pH (MII-pH) monitoring to investigate potential predictors of PPI failure in @entity354 ( @entity354 ) @entity1 . METHODS: One hundred and seventeen @entity354 @entity1 were included, within which there were 44 PPI failure @entity1 . The symptomatic questionnaire GerdQ, HRM and 24-hour MII-pH monitoring were performed before PPI therapy. PPI failure was defined as persistent reflux symptoms for more than 1 day during the last week on @entity1537 (20 mg twice daily) for continuous 4 weeks. The predictors for PPI failure were investigated by multivariable logistic regression analysis. KEY RESULTS: Proton pump inhibitor failure @entity1 had lower body mass index (BMI) and @entity2210 ( @entity2210 ) symptoms. PPI failure @entity1 had a higher percentage of type I esophagogastric junction (EGJ) morphology (p = 0.005), increased EGJ augmentation (p = 0.000), higher prevalence of @entity4423 (p = 0.005) and a higher ratio of negative symptom index (SI, p = 0.000). Multivariable regression analysis showed that concomitance of @entity2210 symptoms, EGJ augmentation and negative SI were independent risk factors for PPI failure in @entity354 . CONCLUSIONS _ INFERENCES: Approximately half of PPI failure @entity1 were found to have @entity4423 in HRM. The independent risk factors for PPI failure in @entity354 were concomitant @entity2210 symptoms, increased EGJ augmentation and negative SI.
