C0222 - Post-Reflux Swallow-Induced Peristaltic Wave Index and Mean Nocturnal Baseline Impedance Predict PPI Response in Patients With Reflux Hypersensitivity

Monday, October 24, 2022

3:00 PM – 5:00 PM ET

Location: Crown Ballroom

Has Audio

Presenting Author(s)

GS

Gengqing Song, MD

MetroHealth Medical Center/Case Western Reserve University
Cleveland, OH

Jie Liu, MSN¹, Wei Wang, MSc¹, Yue Yu, PhD², Gengqing Song, MD³
¹Affiliated Provincial Hospital, Anhui Medical University, Anhui Province, Anhui, China; ²Anhui Provincial Hospital, Hefei, Anhui, China; ³MetroHealth Medical Center/Case Western Reserve University, Cleveland, OH

Introduction: Post-reflux swallow-induced peristaltic wave (PSPW) index and mean nocturnal baseline impedance (MNBI) are associated with proton pump inhibitor (PPI) response in GERD patients. Few data concerning these variables in patients with reflux hypersensitivity (RH) are available. This study aimed to assess, in RH patients, the prevalence of PPI responders and nonresponders, and investigate the role of the predictive value of impedance-pH variables, including PSPW and MNBI for PPI response.

Methods: A total of 108 patients RH patients who met ROME IV criteria were prospectively recruited from June 2018 to May 2021. The prevalence of PPI responders/nonresponders was calculated, and impedance-pH variables were compared between the response and non-response groups. Multiple logistic regression was used to investigate predictors for PPI response.

Results: In a total of 108 patients with RH, 60 patients (55.56%) were the PPI responders, and 48 (44.44%) were the nonresponders. When compared with the nonresponderss, the PPI responders had a lower PSPW index (54.55±14.78 vs. 60.56±13.00, P=0.032) and a decreased value of MNBI (2391.36±337.44 vs. 2595.32±361.14, P=0.017). Multivariate logistic regression revealed that only pathologic PSPW index (OR: 2.064) and MNBI (OR: 1.800) exerted a significant influence on PPI response.

Discussion: Nearly half of RH patients were PPI nonresponders. Pathologic PSPW index and MNBI were independently associated with PPI response in RH patients, highlighting the importance of performing impedance-pH tests.

Figure: Legends:
Figure 1. Flow chart of study participation.
Figure 2.Frequency of each RH in the studied population. The majority of patients presented heartburn(69, 63.89%) and chest pain (60, 55.56%); 75 out of the 108 patients (69.44%) presented typical symptoms. RH: Reflux hypersensitivity.
Figure 3. The comparison of the pathologic PSPW index, pathologic MNBI, AET between 4-6% with total reflux number >80 between PPI response group and non-response group. There were more patients in PPI response group than non-response group (42 vs. 9, P<0.001) with regard to pathologic PSPW index. Meanwhile, more patients in PPI response group were noted for pathologic MNBI (48 vs. 18, P<0.001) and AET between 4-6% with total reflux number >80 (24 vs. 3, P<0.001) when compared with non-response group.

	RH patients(n=108)
	OR	95%CI	P
AET< 4%	1.176	0.297-5.681	0.289
Pathologic PSPW index	2.064	1.356-7.367	0.026
Pathologic MNBI	1.800	0.999-4.302	0.049
Presence of typical symptoms	0.580	0.065-5.156	0.625

Table: Multivariate logistic regression analysis of odds ratio of PPI response in the studied population.

Disclosures:

Jie Liu indicated no relevant financial relationships.

Wei Wang indicated no relevant financial relationships.

Yue Yu indicated no relevant financial relationships.

Gengqing Song indicated no relevant financial relationships.

Jie Liu, MSN¹, Wei Wang, MSc¹, Yue Yu, PhD², Gengqing Song, MD³. C0222 - Post-Reflux Swallow-Induced Peristaltic Wave Index and Mean Nocturnal Baseline Impedance Predict PPI Response in Patients With Reflux Hypersensitivity, ACG 2022 Annual Scientific Meeting Abstracts. Charlotte, NC: American College of Gastroenterology.