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PPI use after negative results from tests for reflux disease

Many patients continue using PPIs after negative results from tests for reflux disease, reports the latest issue of Clinical Gastroenterology & Hepatology.

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Ambulatory reflux testing is used to evaluate symptoms of gastroesophageal reflux disease (GERD) refractory to protein pump inhibitors (PPIs).

Dr Andrew Gawron and colleagues from Illinois, USA investigated the prevalence of PPI use in patients with negative results from Bravo pH or multichannel intraluminal impedance-pH (MII-pH) tests and factors that might predict the use of PPIs.

The researchers analyzed data from patients who had undergone Bravo pH monitoring or MII-pH testing at Northwestern University, without evidence of reflux disease.

Demographics, endoscopy findings, pathology results, and provider recommendations were obtained via chart review.

42% of reported current PPI use despite a negative result
Clinical Gastroenterology & Hepatology

Eligible patients were contacted by telephone, and a cross-sectional survey was administered with questions about symptom severity, demographics, medication use, and health behaviors.

The team found that 42% of reported current PPI use despite a negative result from a pH study.

Only 19% of patients recalled being instructed to stop taking PPIs.

The research team reported that chart review showed documented instructions to stop PPI therapy 17% of patients.

There were no significant differences in demographic or clinical characteristics among patients compared by current PPI use.

Patients taking a PPI were more likely than those not taking a PPI to report troublesome symptoms that affected their daily life, as measured by a questionnaire for the diagnosis of GERD (the GerdQ).

Dr Gawron's team concludes, "More than 42% of patients with negative results from pH monitoring studies continue PPI therapy despite physiological data that they do not have GERD."

Clin Gastroenterol Hepatol 2012: 10(6): 620-625
01 June 2012

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