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document
Possible etiology of improvements in both quality of life and overlapping gastroesophageal reflux disease by proton pump inhibitor treatment in a prospective randomized controlled trial . BACKGROUND Symptoms suggestive of functional dyspepsia ( FD ) and irritable bowel syndrome ( IBS ) frequently overlap with those of gastroesophageal reflux disease . Despite the high prevalence of symptomatic overlap , the underlying etiology remains poorly defined . We assessed the correlation of symptomatic relief and health-related quality of life ( HRQoL ) with healing of reflux esophagitis to further derive insights into the underlying etiology . METHODS 626 patients with reflux esophagitis were enrolled into one of two treatment groups ( classical healing concept or the complete remission concept ) to investigate differences in treatment intensity . Patients were treated with pantoprazole until esophageal mucosal healing . Remission was followed for up to 6 months without treatment . Gastro-intestinal symptoms and HRQoL were analyzed using disease-specific , psychometrically validated patient-reported outcome instruments ( ReQuest™ , GERDyzer™ ) . RESULTS Symptomatic burden reflected by ReQuest™ substantially decreased from baseline to end of treatment by 83 % and 88 % in either treatment group , respectively . ReQuest™ scores significantly decreased in patients with or without heartburn and in those with symptoms suggestive of FD and IBS , indicating response of all symptom categories to treatment ( p < 0.005 ) . Therapy-associated relief of symptoms was paralleled by substantial gains in HRQoL , which continued to stabilize post-treatment . CONCLUSIONS Pantoprazole is effective in relieving upper and lower gastro-intestinal symptoms overlapping with erosive esophagitis , and provides sustained improvement in HRQoL post-treatment . Our results propose a link between both healing of erosive esophagitis and the slower remission of upper and lower gastro-intestinal symptoms . Since the improvement observed is likely to be multifactorial , the possibility for an immune-mediated etiology and identification of putative susceptibility factors by genome-wide association study may provide focus for future research . TRIAL REGISTRATION ClinicalTrials.gov identifier : NCT00325676 .
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Intervention_Physical
classical healing concept
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Intervention_Physical
the complete remission concept
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Intervention_Pharmacological
pantoprazole
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Outcome_Other
quality of life
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Outcome_Physical
and overlapping gastroesophageal reflux disease
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Outcome_Other
symptomatic relief and health-related quality of life ( HRQoL )
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Participant_Sample-size
626
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Participant_Condition
reflux esophagitis