Shuto Yukihiro, Saito Masahiro, Koike Tomoyuki, Koizumi Kaoru, Kaise Yumiko, Yachi Kazuma, Hatayama Yutaka, Ogata Yohei, Jin Xiaoyi, Kanno Takeshi, Hatta Waku, Uno Kaname, Asano Naoki, Imatani Akira, Masamune Atsushi
Division of Gastroenterology, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, Japan.
J Gastroenterol. 2025 May 12. doi: 10.1007/s00535-025-02258-4.
No studies have evaluated the prevalence of supragastric belching (SGB) in Japanese patients with proton pump inhibitor (PPI)-refractory non-erosive reflux disease (NERD) under off-PPI conditions. This study aimed to clarify the association between excessive SGB and esophageal reflux factors.
Seventy-nine patients with PPI-refractory NERD under off-PPI treatment were evaluated using 24-h multichannel intraluminal impedance pH monitoring and high-resolution impedance manometry.
The prevalence values of excessive SGB overall and in the true NERD, reflux hypersensitivity, and function heartburn subtypes were 19.0%, 35.7%, 5.3%, and 12.5%, respectively. The monitoring results demonstrated that, compared with those without excessive SGB, patients with excessive SGB had a significantly higher total number of reflux events (63 episodes vs. 39 episodes, p = 0.01) and significantly greater acid exposure time (6.1% vs. 1.35%, p = 0.01). However, bolus exposure did not differ significantly between the groups (p = 0.09). The manometry findings showed no significant differences in lower esophageal sphincter pressure, integrated relaxation pressure, and distal contractile integral between the groups. Regarding gastroesophageal reflux, 22% of the SGB episodes were preceded by reflux, 55% occurred independently, and 23% were followed by reflux.
The prevalence of excessive SGB in Japanese patients with PPI-refractory NERD under off-PPI conditions was 19.0% and most commonly observed in patients with true NERD (35.7%). Patients with excessive SGB exhibited increased esophageal acid exposure, and reflux events were sometimes observed before SGB episodes.
尚无研究评估在停用质子泵抑制剂（PPI）的情况下，日本质子泵抑制剂难治性非糜烂性反流病（NERD）患者中胃上嗳气（SGB）的患病率。本研究旨在阐明过度胃上嗳气与食管反流因素之间的关联。
对79例在停用PPI治疗下的质子泵抑制剂难治性NERD患者进行24小时多通道腔内阻抗pH监测和高分辨率阻抗测压。
总体上以及在真性NERD、反流高敏和功能性烧心亚型中，过度胃上嗳气的患病率分别为19.0%、35.7%、5.3%和12.5%。监测结果表明，与无过度胃上嗳气的患者相比，有过度胃上嗳气的患者反流事件总数显著更高（63次发作 vs. 39次发作，p = 0.01），酸暴露时间显著更长（6.1% vs. 1.35%，p = 0.01）。然而，两组间团块暴露无显著差异（p = 0.09）。测压结果显示，两组间食管下括约肌压力、综合松弛压力和远端收缩积分无显著差异。关于胃食管反流，22%的胃上嗳气发作之前有反流，55%独立发生，23%之后有反流。
在停用PPI的情况下，日本质子泵抑制剂难治性NERD患者中过度胃上嗳气的患病率为19.0%，最常见于真性NERD患者（35.7%）。有过度胃上嗳气的患者食管酸暴露增加，且有时在胃上嗳气发作之前观察到反流事件。
