Efficacy of Proton Pump Inhibitor–Prokinetic Combination Therapy in Patients with Refractory Gastroesophageal Reflux Disease Symptoms
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Abstract
This randomized clinical trial evaluated the treatment outcomes of proton pump inhibitor (PPI) therapy combined with a prokinetic agent in patients with refractory gastroesophageal reflux disease symptoms (GERD). The study enrolled 81 patients who were allocated to two treatment regimens: double-dose esomeprazole (n = 38) and esomeprazole 40 mg combined with mosapride (n = 43). Clinical symptoms, GERQ score, and FSSG score were assessed at baseline, 4 weeks and 8 weeks, and high-resolution manometry (HRM) was performed at baseline and after 8 weeks. After 8 weeks of treatment, there was a significant improvement in symptoms, demonstrated by reductions in FSSG total and reflux scores in both groups (p < 0.01). In the group treated with Esomeprazole and Mosapride, the proportion of failed swallows decreased, and the proportion of normal swallows and lower esophageal sphincter pressure on HRM increased after treatment (p < 0.05). The combination of a PPI and prokinetic showed efficacy in improving clinical symptoms and HRM parameters in patients with refractory GERD. Changes in HRM parameters after treatment were not significant in the high-dose PPI group (p < 0.05).
Article Details
Keywords
Refractory GERD, PPI, Prokinetic, HRM, Treatment response
References
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