Factors affecting efficacy of gastroesophageal reflux disease treatment with proton pump inhibitors

Abstract

Aim. The aim of the study was to determine causes of proton pump inhibitors (PPIs) inefficacy in some patients suffering from gastroesophageal reflux disease (GERD). Material and methods. In our study of 154 GERD patients, 50 received omeprazole, 51 - lansoprazole and 53 - pantoprazole in a standard daily dose. GERD symptoms (heartburn and regurgitation) were scored by Likert scale; the patients' quality of life (SF-36) and their mental status (SMALL) were examined. Upper gastrointestinal endoscopy, 24-h intraesophageal pH monitoring, esophageal manometry and pharmacokinetic study were performed. Results. The treatment with a standard dose of PPIs was ineffective in 21 (13.6%) patients. Causes of PPIs inefficacy in 4.5% patients were rapid PPI metabolism and in 9.1% - "driving gear" of symptoms formation related with psychic dysadaptation.

Keywords

• gastroesophageal reflux disease
• quality of life
• mental status
• ppis pharmacokinetics