2017 Volume 57 Issue 4 Pages 357-361
Gastroesophageal reflux disease (GERD) is defined as a condition which develops when the reflux of gastric content causes troublesome symptoms and/or complications. GERD is categorized into erosive reflux esophagitis, defined as the presence of esophageal mucosal breaks, and nonerosive reflux disease (NERD), defined as the presence of reflux-associated symptoms without esophageal mucosal breaks. Proton pump inhibitor (PPI) is generally the first choice of treatment for GERD. However, some GERD patients experience persistent and troublesome symptoms despite PPI therapy and they reduce health-related quality of life (HRQOL). We examined the relationship between efficacy of PPI and HRQOL to evaluate predictive factors affecting response to PPI, in Japanese GERD patients receiving PPI therapy. In this study, we used of the gastroesophageal reflux disease questionnaire (Gerd Q), 8-item Short Form health Survey (SF-8), Pittsburgh Sleep Quality Index (PSQI) and Hospital Anxiety and Depression Scale (HADS) to 145 GERD patients receiving PPI therapy. Using Gerd Q, we classified them in well controlled patients to PPI therapy (responders) and not well controlled patients (partial responders). Using SF-8, PSQI, and HADS, we evaluated HRQOL of responders and partial responders. Sixty-nine patients (47.6%) were partial responders. Partial responders had significantly lower scores in five of eight subscales and in mental health component summary in SF-8 than those of responders. Partial responders had significantly higher scores of PSQI and HADS including anxiety and depression than those of responders. Non-erosive reflux disease and double PPI dose were predictive factors of partial responders. In conclusion, Persistent reflux symptoms despite PPI therapy caused mental health disorder, sleep disorder, psychological distress in Japanese GERD patients.
