ArticleNeurogastroenterology and motility2016
Prevalence, characteristics, and treatment outcomes of reflux hypersensitivity detected on pH-impedance monitoring.
Article in Neurogastroenterology and motility, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers.
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Who cites it
19 citing papers in PubMed, 62 citations in OpenAlex.
- The Efficacy of Potassium-Competitive Acid Blocker Compared With Double Dose of Proton Pump Inhibitor in Patients With Refractory Gastro-Esophageal Reflux Disease: A Case-Control Study.The Korean journal of helicobacter and upper gastrointestinal research · 2025Article
- Clinical characteristics and risk factors of esophageal reflux hypersensitivity: A multicenter study.World journal of gastroenterology · 2025Article
- Validation of Esophageal Global Symptom Severity as a Patient-Reported Outcome for Evaluation of Reflux Symptoms.The American journal of gastroenterology · 2025Article
- Is reflux hypersensitivity truly a functional gastrointestinal disorder? A retrospective cross-sectional study.PloS one · 2025Article
- Esophageal Reflux Hypersensitivity: A Comprehensive Review.Gut and liver · 2023Review
- Correlation between Psychosomatic Assessment, Heart Rate Variability, and Refractory GERD: A Prospective Study in Patients with Acid Reflux Esophagitis.Life (Basel, Switzerland) · 2023Article
- Application of Artificial Intelligence in Measuring Novel pH-Impedance Metrics for Optimal Diagnosis of GERD.Diagnostics (Basel, Switzerland) · 2023Review
- 2020 Seoul Consensus on the Diagnosis and Management of Gastroesophageal Reflux Disease.Journal of neurogastroenterology and motility · 2021Review
- Diagnosis and Management of Refractory Gastroesophageal Reflux Disease.Gastroenterology & hepatology · 2021Article
- Non-acid Reflux: What to Do When You Don't Feel the Burn.Digestive diseases and sciences · 2021Article
- Provider Variability in the Management Patterns of Increased Nonacid Reflux.Digestive diseases and sciences · 2021Article
- pH Impedance Parameters Associated with Improvement in GERD Health-Related Quality of Life Following Anti-reflux Surgery.Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · 2021Article
- Higher Esophageal Symptom Burden in Obese Subjects Results From Increased Esophageal Acid Exposure and Not From Dysmotility.Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association · 2020Article
- The Spectrum of Reflux Phenotypes.Gastroenterology & hepatology · 2019Article
- Review
- Genetic risk factors for perception of symptoms in GERD: an observational cohort study.Alimentary pharmacology & therapeutics · 2018Observational
- Expert consensus document: Advances in the physiological assessment and diagnosis of GERD.Nature reviews. Gastroenterology & hepatology · 2017Review
- Reflux Hypersensitivity: A New Functional Esophageal Disorder.Journal of neurogastroenterology and motility · 2017Review
- Critical appraisal of Rome IV criteria: hypersensitive esophagus does belong to gastroesophageal reflux disease spectrum.Annals of gastroenterologyReview
Corrections and comments
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Authors and funding
3 authors at 1 institution in 1 country.
Funding
Abstract
backgroundPositive symptom association probability (SAP) with physiologic esophageal acid exposure time (AET) on pH-impedance monitoring defines reflux hypersensitivity (RH), a correlate of acid sensitivity on pH monitoring. We evaluated prevalence, clinical characteristics, and symptomatic outcomes of RH in a prospective observational cohort with reflux symptoms undergoing pH-impedance monitoring.
methodsReflux hypersensitivity was diagnosed when SAP was positive with pH- and/or impedance-detected reflux events with physiologic AET. Symptom burden was assessed using dominant symptom intensity (DSI, product of symptom severity and frequency on 5-point Likert scales) and global symptom severity (GSS, global esophageal symptoms on 100-mm visual analog scales) by questionnaire, both at baseline and on prospective follow-up. Clinical characteristics and predictors of symptomatic improvement were assessed with univariate and multivariate analyses. KEY
resultsSeventy-seven patients (29%) met criteria for RH, of which 53 patients (53.7 ± 1.8 years, 66% F) were contacted after 3.3 ± 0.2 years for follow-up. Reflux hypersensitivity was detected on pH-impedance testing both on and off antisecretory therapy; pH alone missed 51% of RH. About 57% reported ≥50% GSS improvement. Sixteen patients undergoing antireflux surgery (ARS) reported better symptom improvement compared to 37 patients treated medically (GSS change: p = 0.005; DSI change: p = 0.04). Hiatus hernia (p = 0.03) and surgical management (p ≤ 0.04) predicted symptom improvement on univariate analysis, while acid sensitivity was a negative predictor for outcome on both univariate (p = 0.02) and multivariate analyses (p ≤ 0.04). CONCLUSIONS & INFERENCES: Reflux hypersensitivity is a mechanism for persistent reflux symptoms in almost one-third of patients undergoing pH-impedance testing. While acid sensitivity predicts suboptimal symptom improvement, antireflux therapy may improve RH in select settings.
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