[The impact of proton pump inhibitors on esophageal acid exposure in gastroesophageal reflux disease].

OBJECTIVE: To explore the effects of proton pump inhibitors (PPIs) therapy on esophageal acid exposure of patients with gastroesophageal reflux disease (GERD), and the correlation of anxiety and depression with recurrence of acid-related symptoms after discontinuation of PPIs. METHODS: From February 2010 to June 2011, 28 patients with GERD diagnosed by ambulatory 24 h esophageal pH monitoring admitted to Beijing Jishuitan Hospital were treated with esomeprazole 20 mg 2 times/d for 8 weeks (male 16, female 12). Symptoms after drug discontinuation were monitored. Ambulatory 24 h esophageal pH monitoring was performed on patients, whose symptom recurred within 8 weeks after treatment. BMI, Self-rating Anxiety Scale (SAS), and Self-rating Depression Scale (SDS) were detected. RESULTS: Among the 28 patients with GERD, 15 (53.6%) recurred symptoms after withdraw of PPIs. Compared with the asymptomatic group after withdraw of PPIs, the pretreatment duration of pH 4 (supine), 24 h total acid reflux time, number of time periods with acid reflux > 5 minutes, the maximal acid reflux time and 24 h total number of acid reflux in the symptomatic recurrence group were statistically significantly increased (11.7% vs 4.5%, 138.8 minutes vs 62.1 minutes, 6.0 vs 2.0, 27.0 minutes vs 12.4 minutes, 74.0 times vs 43.0 times, respectively, all P values < 0.05). There were no significant differences in BMI, SAS and SDS between the two groups. CONCLUSIONS: The basic level of esophageal acid exposure of patients with GERD before PPIs therapy may influence the esophageal acid exposure after PPIs therapy and then may affect the recurrence of symptoms. Although anxiety and depression is common in patients with GERD, it is not found that the recurrence of acid-related symptoms after the discontinuation of PPIs therapy is related to the anxiety and depression.