Risk factors for low response to proton‑pump inhibitor treatment in reflux esophagitis and non‑erosive reflux disease evaluated by the frequency scale for the symptoms of gastroesophageal reflux disease

Background This study aimed to evaluate risk factors for resistance to proton-pump inhibitor (PPI) therapy among patients with reflux esophagitis (RE) and nonerosive reflux disease (NERD) in gastroesophageal reflux disease (GERD) using a standardized questionnaire in Japan: the Frequency Scale for the Symptoms of Gastroesophageal Reflux Disease (FSSG). Methods One hundred fifty-eight patients who underwent upper gastrointestinal endoscopy were enrolled: 87 were diagnosed with RE (mean age: 59.5 ± 15.1 years; male/female: 47/39) and 71 with NERD (mean age 53.0 ± 17.6 years; male/female 22/49). The patients were divided into two groups according to improvement afterPPI treatment evaluated by FSSG: rapid responders were patients with ≥50% improvement according to FSSG, and low responders were those with <50% improvement according to FSSG. All patients were treated with the PPI rabeprazole (10 mg/day) for 4 weeks. Results Response rate to PPI therapy was 65.5% (57/87) in RE and 54.9% (39/71) in NERD, indicating that the PPI treatment was more effective for RE. In RE, risk factors for PPI resistance indicated by univariate analysis were low stature and high body mass index. Low stature was a risk factor in multivariate analysis. With regard to NERD, univariate analysis indicated that female gender, high stature, low body weight, and low total FSSG score were risk factors for PPI resistance. Low FSSG score was a risk factor in multivariate analysis. Conclusions By the present study, we identified the risk factors for PPI resistance in RE and GERD using FSSG.