Limited Role of pH Monitoring in Nonresponders to Twice-Daily PPI Therapy

Proton-pump inhibitors (PPIs) have revolutionized our approach to both the diagnosis and treatment of gastroesophageal reflux disease (GERD). Although a trial of empirical PPI therapy . . .

Proton-pump inhibitors (PPIs) have revolutionized our approach to both the diagnosis and treatment of gastroesophageal reflux disease (GERD). Although a trial of empirical PPI therapy has become standard for patients with suspected GERD or related extraesophageal complications, an emerging subset of patients are nonresponders. In this retrospective analysis, researchers examined the value of pH monitoring in 250 symptomatic patients at Cleveland Clinic who underwent pH monitoring while taking a PPI (once or twice daily). Normal pH values were defined according to standards for testing patients on PPI therapy (cutoff for percent total time pH <4, 1.6%).

The predominant symptoms were heartburn (45% of patients), regurgitation (40%), chest pain…

Reviewing Author

David A. Johnson, MD