Clinical symptoms of FSSG in gastroesophageal reflux disease are critical for PPI treatment: Japanese multi-centers with 185 patients

Aim: The main aim of this study was to determine whether questionnaire evaluations of clinical symptoms in gastroesophageal reflux discase were useful to assess proton pump inhibitor therapy. Methods: A total of 185 Japanese patients (men, 88 ; women, 97 ; age : 55.7 ± 16.1 years) with gastroesophageal reflux disease were enrolled. The patients were divided based on the frequency scale for symptoms of gastroesophageal reflux disease : severe symptoms with scores ≥8 and mild symptoms with scores ≤7. Quality of life was evaluated with the Medical Outcomes Study 8-Item Short-Form Health Survey. All patients were treated with a proton pump inhibitor, rabe-prazole (10mg/day), for 8 weeks. Results: Patients were classified into four groups : reflux esophagitis with severe symptoms (n=92, 49.7%) ; reflux esophagitis with mild symptoms (n=17, 9.2%) ; non-erosive reflux disease with severe symptoms (n=66, 35.7%) ; and non-erosive reflux disease with mild symptoms (n=10, 5.4%). The dysmotility score was high in non-erosive reflux disease with severe symptoms compared with reflux esophagitis with severe symptoms (9.1 ± 0.5 vs 6.8 ± 0.5, P<0.05). The symptom score and quality of life in the severe symptoms groups for both reflux esophagitis and non-erosive reflux disease were significantly improved by rabeprazole treatment. Only the reflux score was improved by rabeprazole in the reflux esophagitis with mild symptoms group ; no therapeutic effect was observed for the non-erosive reflux disease with mild symptoms group. Conclusions: Low scores on the frequency scale for the symptoms of gastroesophageal reflux disease indicate poor responsiveness to proton pump inhibitor treatment, and high scores indicate good responsiveness.