Patients With Extra-Esophageal Symptoms, Compared to NERD Patients With Typical Symptoms and Healthy Volunteers, Are Characterized by a Higher Number of Reflux Episodes and Higher Proportion of Weakly Acidic and Mixed Reflux

OC.03.5 – Table 1. Reflux parameters in subgroups of NERD patients and HV patients pH-POS/SAP+ pH-POS/SAPpH-NEG/SAP+ pH-NEG/SAPHV p-value (ANOVA) % pH <4 total 6.2 (4.6-9)b,c,d 4.5 (4.4-6.3)e,f,g 1.7 (0.7-2.7)b,e,h,i 0.8 (0.3-1.8)c,f,h 0.7 (0.1-1.4)d,g,i <0.01 MACT total 136 (88-181)a,b,c,d 85 (78-269)a,e,f,g 43 (27-67)b,e 41 (22-70)c,f 32 (16-50)d,g <0.01 MBCT total 16 (13-22)b,c,d 15 (13-21)e,f,g 13 (10-18)b,e, 12 (10-19)c,f 12 (8-16)d,g <0.01 Prox. extent (%) 52 (39-62)a,c,d 33 (22-55)a,e 57 (42-69)e,h,i 33 (23-49)c,h 33 (18-46)d,i <0.01 Data are presented as median (25th-75th percentile). Post-hoc analysis. apH-POS/SAP+ vs. pH-POS/SAP-, p<0.05; bpH-POS/SAP+ vs. pH-NEG/SAP+, p<0.05; cpH-POS/SAP+ vs. pH-NEG/SAP-, p<0.05; dpH-POS/SAP+ vs. HV, p<0.05; epH-POS/SAPvs. pH-NEG/SAP+, p<0.05; fpH-POS/SAPvs. pH-NEG/SAP-, p<0.05; gpH-POS/SAPvs. HV, p<0.05; hpH-NEG/SAP+ vs. pH-NEG/SAP-, p<0.05; ipH-NEG/SAP+ vs. HV, p<0.05. PPI non responder and 6/25 responder patients. Findings of MI-pH are shown in the table. The total reflux number and the proportions of weakly acidic, mixed and proximal reflux did not differ between EE patients (PPI responders and non-responders). Number of refluxes Weakly acidic Mixed reflux Proximal (%) (%) (%) EE 62 (39-113)* 51% (34-64%)* 71% (43-84%)* 68% (59-80%) EE only/ 56 (37-105)/ 51% (35-68%)/ 70% (43-84%)/ 68% (61-78%)/ EE+T 66 (46-134) 50% (31-63%) 75% (54-84%) 67% (53-82%) NERD 28 (20-41) 32% (16-42%) 54% (45-70%) 64% (30-78%) HV 16 (9-27) 43% 58% 62% *p< 0.05. Data are expressed as median and 25th–75th percentile values. Conclusions: Patients with extra-esophageal symptoms, compared to NERD patients with typical symptoms and HV, are characterized by a higher number of reflux episodes and higher proportion of weakly acidic and mixed refluxes. Although this reflux pattern could explain the reduced response to PPI treatment, MI-pH findings do not seem to predict the PPI response in this group of patients.