Link between pharyngeal acid reflux episodes and the effectiveness of proton pump inhibitor therapy

doi:10.3748/wjg.v30.i48.5162

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Dec 28, 2024 (publication date) through Dec 2, 2024

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World Journal of Gastroenterology

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1007-9327

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

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World J Gastroenterol. Dec 28, 2024; 30(48): 5162-5173
Published online Dec 28, 2024. doi: 10.3748/wjg.v30.i48.5162

Table 3 Manometric and 24-hour potential of hydrogen findings

Finding	PAR¹ alone (n = 11)	EAR² alone (n = 68)	Both pH (+) (n = 18)	Both pH (-) (n = 93)	P value (4-group comparison)
24-hour pH findings
Distal esophagus
Total time pH < 4, median (IQR)	1.2 (0.9, 2.1)⁶^,⁷	6.1 (4.5, 8.5)⁴	7.6 (4.7, 11.9)⁵	0.6 (0.1, 1.5)	< 0.0001
Upright time pH < 4, median (IQR)	2.2 (1.3, 3.4)⁶^,⁷	8.1 (6.1, 12.1)⁴	9.1 (7.4, 14.3)⁵	0.9 (0.2, 2.3)	< 0.0001
Supine time pH < 4, median (IQR)	0.0 (0.0, 0.2)³^,⁶^,⁷	1.3 (0.0, 4.5)⁴	1.4 (0.2, 10.1)⁵	0.0 (0.0, 0.0)	< 0.0001
Pharynx
Number of PAR event, total, median (IQR)	5 (2, 10)³^,⁶	0 (0, 0)⁴^,⁸	3 (2, 6)⁵	0 (0, 0)	< 0.0001
Number of PAR event, upright, median (IQR)	5 (2, 9)³^,⁶	0 (0, 0)⁴^,⁸	3 (2, 5)⁵	0 (0, 0)	< 0.0001
Number of PAR event, supine, median (IQR)	0 (0, 1)³^,⁶	0 (0, 0)⁴^,⁸	0 (0, 0)⁵	0 (0, 0)	0.0002
Manometric findings
Lower esophageal sphincter, median (IQR), mmHg	19 (15, 27)⁶^,⁷	13 (10, 20)⁸	9 (7, 11)⁵	16 (10, 27)	0.0002
Upper esophageal sphincter, median (IQR), mmHg	32 (22, 87)	30 (18, 48)⁴^,⁸	15 (7, 28)⁵	38 (25, 54)	0.0002
Ineffective esophageal motility, n (%)	1 (14)	14 (33)	3 (27)	13 (24)	0.6

Esophageal sensation
Bernstein test, n (%)	4 (36)	21 (31)⁴	9 (50)⁵	14 (15)	0.01
Symptom index, n (%)	3 (27)	24 (35)⁴^,⁸	12 (67)⁵	17 (18)	0.0003

¹Excessive pharyngeal acid reflux is defined as pharyngeal acid reflux ≥ 2 episodes.

²Excessive distal esophageal acid reflux is defined as distal esophageal acid reflux total time ≥ 4.2% of 24-hour, or ≥ 6.3% of upright position, or ≥ 1.2% of supine position.

³P < 0.05 for pharyngeal acid reflux alone vs both pH (-).

⁴P < 0.05 for esophageal acid reflux alone vs both pH (-).

⁵P < 0.05 for both pH (+) vs both pH (-).

⁶P < 0.05 for pharyngeal acid reflux alone vs esophageal acid reflux alone.

⁷P < 0.05 for pharyngeal acid reflux alone vs both pH (+).

⁸P < 0.05 for esophageal acid reflux alone vs both pH (+).

EAR: Esophageal acid reflux; IQR: Interquartile range; PAR: Pharyngeal acid reflux; pH: Potential of hydrogen.

Citation: Chen YY, Wang CC, Chuang CY, Tsou YA, Peng YC, Chang CS, Lien HC. Link between pharyngeal acid reflux episodes and the effectiveness of proton pump inhibitor therapy. World J Gastroenterol 2024; 30(48): 5162-5173
URL: https://www.wjgnet.com/1007-9327/full/v30/i48/5162.htm
DOI: https://dx.doi.org/10.3748/wjg.v30.i48.5162