ArticleGastroenterology2021
Ambulatory Reflux Monitoring Guides Proton Pump Inhibitor Discontinuation in Patients With Gastroesophageal Reflux Symptoms: A Clinical Trial.
Article in Gastroenterology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03202537 (Effectiveness of Physiologic Testing in PPI Non-Responders), which is not on this map. Cited by 28 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Effectiveness of Physiologic Testing in PPI Non-Responders
Who cites it
28 citing papers in PubMed, 1 synthesis or guideline pooled it, 74 citations in OpenAlex.
- AGA Clinical Practice Update on the Personalized Approach to the Evaluation and Management of GERD: Expert Review.Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association · 2022Guideline
- Gastroesophageal Reflux Disease and Reflux-like Phenotypes: Using Lyon Consensus 2.0 to Guide Clinical Approach.Journal of neurogastroenterology and motility · 2026Review
- Laryngopharyngeal Symptoms and Laryngopharyngeal Reflux Disease: Diagnostic Testing and Clinical Approach Based on the San Diego Consensus.Neurogastroenterology and motility · 2026Review
- Gatherings in Esophagology: Innovations and Future Directions in the Diagnosis and Management of Reflux Disease.Annals of the New York Academy of Sciences · 2026Article
- Can the Mean Nocturnal Baseline Impedance/Acid Exposure Time Ratio Serve as a Novel Parameter for the Definitive Diagnosis of Pathological Reflux?Journal of clinical medicine · 2025Article
- Clinical Application of Lyon Consensus 2.0 in Asia: An Overview.Gut and liver · 2025Review
- Reflux Testing: Wireless pH, Impedance-pH, and Mucosal Impedance.Gastrointestinal endoscopy clinics of North America · 2025Review
- Management of Patients With Refractory Reflux-Like Symptoms Despite Proton Pump Inhibitor Therapy: Evidence-Based Consensus Statements.Alimentary pharmacology & therapeutics · 2025Article
- Optimizing the Management Algorithm for Heartburn in General Gastroenterology: Cost-Effectiveness and Cost-Minimization Analysis.Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association · 2024Article
- Proton Pump Inhibitor Prescription in Nursing Home Residents: Prevalence, Appropriateness, and Associated Factors-A Secondary Data Analysis from Three German Regions and the Impact of Guideline Recommendations.Pharmaceuticals (Basel, Switzerland) · 2024Article
- Rebound Acid Hypersecretion after Withdrawal of Long-Term Proton Pump Inhibitor (PPI) Treatment-Are PPIs Addictive?International journal of molecular sciences · 2024Review
- Prolonged acid reflux monitoring using acid exposure time and DeMeester score: two days are not enough.Surgical endoscopy · 2024Article
- Review article: Diagnosis and management of laryngopharyngeal reflux.Alimentary pharmacology & therapeutics · 2024Review
- Refractory Gastroesophageal Reflux Disease: Diagnosis and Management.Journal of neurogastroenterology and motility · 2024Review
- Review
- Functional lumen imaging probe topography identifies patients with normal acid exposure and esophageal hypervigilance amongst proton-pump inhibitor non-responders.Surgical endoscopy · 2024Article
- A scientometrics analysis and visualization of refractory gastroesophageal reflux disease.Frontiers in pharmacology · 2024Article
- The role of magnetic sphincter augmentation in the gastroesophageal reflux disease treatment pathway: the gastroenterology perspective.Diseases of the esophagus : official journal of the International Society for Diseases of the Esophagus · 2023Article
- Transoral incisionless fundoplication for recurrent symptoms after laparoscopic fundoplication.Surgical endoscopy · 2023Article
- Application of Artificial Intelligence in Measuring Novel pH-Impedance Metrics for Optimal Diagnosis of GERD.Diagnostics (Basel, Switzerland) · 2023Review
Corrections and comments
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Authors and funding
12 authors at 7 institutions in 1 country.
Funding
Abstract
BACKGROUND AND
aimsProton pump inhibitor (PPI) therapy fails to provide adequate symptom control in up to 50% of patients with gastroesophageal reflux symptoms. Although a proportion do not require ongoing PPI therapy, a diagnostic approach to identify candidates appropriate for PPI cessation is not available. This study aimed to examine the clinical utility of prolonged wireless reflux monitoring to predict the ability to discontinue PPIs.
methodsThis double-blinded clinical trial performed over 3 years at 2 centers enrolled adults with troublesome esophageal symptoms of heartburn, regurgitation, and/or chest pain and inadequate PPI response. Participants underwent prolonged wireless reflux monitoring (off PPIs for ≥7 days) and a 3-week PPI cessation intervention. Primary outcome was tolerance of PPI cessation (discontinued or resumed PPIs). Symptom burden was quantified using the Reflux Symptom Questionnaire electronic Diary (RESQ-eD).
resultsOf 128 enrolled, 100 participants met inclusion criteria (mean age, 48.6 years; 41 men). Thirty-four participants (34%) discontinued PPIs. The strongest predictor of PPI discontinuation was number of days with acid exposure time (AET) > 4.0% (odds ratio, 1.82; P < .001). Participants with 0 days of AET > 4.0% had a 10 times increased odds of discontinuing PPI than participants with 4 days of AET > 4.0%. Reduction in symptom burden was greater among the discontinued versus resumed PPI group (RESQ-eD, -43.7% vs -5.3%; P = .04).
conclusionsAmong patients with typical reflux symptoms, inadequate PPI response, and absence of severe esophagitis, acid exposure on reflux monitoring predicted the ability to discontinue PPIs without symptom escalation. Upfront reflux monitoring off acid suppression can limit unnecessary PPI use and guide personalized management. (ClinicalTrials.gov, Number: NCT03202537).
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.