Endoscopy 2018; 50(04): S137
DOI: 10.1055/s-0038-1637441
ESGE Days 2018 ePosters
Georg Thieme Verlag KG Stuttgart · New York

PROSPECTIVE STUDY ON THE EFFECT OF ILAPRAZOLE ON PATIENTS WITH HEARTBURN BUT WITHOUT REFLUX ESOPHAGITIS, FOCUSED ON HISTOLOGIC FINDINGS AND INFLAMMATORY BIOMARKERS

IJ Song
1   Yonsei University College of Medicine, Internal Medicine, Seoul, Korea, Republic of
,
HK Kim
2   Yonsei University College of Medicine, Department of Pathology, Seoul, Korea, Republic of
,
SK Lee
1   Yonsei University College of Medicine, Internal Medicine, Seoul, Korea, Republic of
› Author Affiliations
Further Information

Publication History

Publication Date:
27 March 2018 (online)

Also available ateRef
 

Aims:

Patients who had gastroesophageal reflux disease without esophagitis showed variable response to proton pump inhibitors (PPIs) than patients with erosive esophagitis. The aim of this study was to objectively evaluate the effect of a new PPI, ilaprazole, on the patients with heartburn but without reflux esophagitis, assessed using symptom scores, histologic findings, and inflammatory biomarkers.

Methods:

This prospective study was performed at a single hospital and 20 patients with heartburn but without reflux esophagitis. All patients underwent upper endoscopy and 24-hr combined multichannel intraluminal impedance and pH esophageal monitoring (MII-pH). Then they were treated with ilaprazole (20 mg) once daily for 4 weeks. The GerdQ questionnaire, histologic findings (basal cell hyperplasia, papillary elongation, dilated intercellular spaces, intraepithelial eosinophils, and intraepithelial T lymphocytes), and inflammatory biomarkers (TNF-α, IL-8, IL-1β, TRPV1, and MCP-1) were used for assessment before and after ilaprazole.

Results:

Among 20 patients, twelve patients (60%) showed GerdQ score ≥8. Based on MII-pH results, patients were classified as 2 true non-erosive reflux disease (NERD), 10 hypersensitive esophagus and 8 functional heartburn. After treatment, patients showed a statistically significant improvement in GerdQ score (P < 0.001). In the histopathologic findings, basal cell hyperplasia, papillary elongation and infiltration of intraepithelial T lymphocytes improved significantly (P = 0.008, P = 0.021, P = 0.008; respectively). This histologic improvement was not observed in functional heartburn, but only in reflux subtypes including true NERD and hypersensitive esophus. Expression of TNF-α, IL-8, TRPV1, and MCP1 decreased marginally after treatment (P = 0.049, P = 0.046, P = 0.045, and P = 0.042; respectively).

Conclusions:

Daily ilaprazole (20 mg) is efficacious in improving symptom scores, histopathologic findings, and inflammatory biomarkers in the patient with heartburn but without reflux esophagitis.