EVALUATION OF REFRACTORY HEARTBORN ; IS IT

Dr. Sanjay Kumar; Dr Vinod Narkede; Dr Sandesh Sharma; Dr Pranav Raghuwanshi

Volume : VII, Issue : II, February - 2018

EVALUATION OF REFRACTORY HEARTBORN ; IS IT

Dr. Sanjay Kumar, Dr Vinod Narkede, Dr Sandesh Sharma, Dr Pranav Raghuwanshi

Abstract :

Introduction: Heartburn and non cardiac chest pain is a common symptom. It is known that excessive intraesophageal acid exposure causes the symptoms of retrosternal pain and burning. But many patients with chronic heartburn symptoms have no endoscopically or histologically discernible esophageal mucosal damage and many of them even do not have positive reflux as per 24-h pH monitoring.

Methodology: A retrospective study was carried out from July 2014 to July 2015. A total of 53 eligible study subjects (35 males, 18 females) [range 19 to 62 years] presented to OPD of gastrocare hospital were included. All study subjects who were having symptoms of Gastro Esophageal Reflux Disease, endoscopically negative, were not responding / partially responding to the standard dose of proton pup inhibitor were considered for 24–h esophageal pH monitoring ( after off PPI for 7 days). Acid contact time, Demeester score, symptom index and symptom associated probability was recorded.

Results: Out of 53 subjects 73.6% had heartburn and chest pain as their presenting complaints while 26.4 had other symptoms of GERD. 41.5% were having hypersensitive esophagus (HE), 22.6% had Nonerosive Reflux Disease (NERD), 18.9% had NERD with HE and 17% subjects had normal pH monitoring

Conclusion: Unfortunately, not all available drugs (namely 5-HT3 antagonists and opioids), capable of reducing visceral perception in the lower gastrointestinal tract, seem to be effective in the upper gastrointestinal tract. Therefore, reduction of the stimulus intensity (diet and PPI) remains at present the only alternative in clinical practice.