BACKGROUND: Patients with chronic autoimmune atrophic gastritis (CAAG) often refer digestive symptoms and are prescribed antisecretory medications. Aims were to investigate: (i) gastro-esophageal reflux (GER), (ii) psychopathological profile, (iii) frequency of use and clinical benefit of antisecretory drugs. METHODS: Prospective observational study on 41 CAAG patients who underwent: 24 h multichannel intra-luminal impedance-pH (MII-pH) monitoring off-therapy, standardized medical interview and psychological questionnaire (i.e., SCL-90R). The medical interview was repeated at least 1 month after MII-pH in patients who were using antisecretory drugs. Statistical analysis was performed calculating median (10th-90th percentiles) and risk ratios (RR) with 95% confidence interval. KEY RESULTS: Median intra-gastric pH was 6.2 (4.6-7.0). One patient had acid reflux (AC) associated with symptoms, five had increased total reflux number and four had symptoms associated to non-acid reflux (NA) (patients referred as 'GER positive'). Using patients 'GER negative' with normal SCL-90R as reference, the RR of being symptomatic in patients GER positive was 2.1 (1.1-4.1) if SCL-90R was normal and 0.9 (0.5-1.7) if it was altered (difference in RR significant being p = 0.04). Seventeen/28 (61%) symptomatic patients were on antisecretory drugs, which were stopped in 16 of them according to results of MII-pH and clinical evaluation after 574 days (48-796) showed that symptoms were unchanged. CONCLUSIONS & INFERENCES: In patients with CAAG (i) AC reflux rarely occurred whereas increased NA reflux was not infrequent both being related to symptoms in some patients, (ii) psychopathological profile has a role in symptoms' occurrence, (iii) antisecretory drugs were generally inappropriately used and clinically ineffective.
Gastro-esophageal reflux and antisecretory drugs use among patients with chronic autoimmune atrophic gastritis : a study with pH-impedance monitoring / A. Tenca, S. Massironi, D. Pugliese, D. Consonni, A. Mauro, F. Cavalcoli, M. Franchina, M. Spampatti, D. Conte, R. Penagini. - In: NEUROGASTROENTEROLOGY AND MOTILITY. - ISSN 1350-1925. - 28:2(2016 Feb), pp. 274-280.
|Titolo:||Gastro-esophageal reflux and antisecretory drugs use among patients with chronic autoimmune atrophic gastritis : a study with pH-impedance monitoring|
TENCA, ANDREA (Primo)
MASSIRONI, SARA (Secondo)
CONTE, DARIO (Penultimo)
PENAGINI, ROBERTO (Ultimo)
|Parole Chiave:||acid-related disorder; autoimmune disease; functional disease|
|Settore Scientifico Disciplinare:||Settore MED/12 - Gastroenterologia|
|Data di pubblicazione:||feb-2016|
|Data ahead of print / Data di stampa:||15-nov-2015|
|Digital Object Identifier (DOI):||http://dx.doi.org/10.1111/nmo.12723|
|Appare nelle tipologie:||01 - Articolo su periodico|