ESOPHAGEAL MANOMETRY COMBINED WITH PROTON PUMP INHIBITOR TEST APPLIED IN THE DIAGNOSIS OF NON-CARDIAC CHEST PAIN ASSOCIATED WITH GASTRO-ESOPHAGEAL REFLUX DISEASE.
Main Article Content
Keywords
high resolution esophageal manometry, proton pump inhibitor, non-cardiogenic chest pain, gastro esophageal reflux disease, diagnostic efficacy, antispasmodic drugs
Abstract
Background: Esophageal manometry (EM) and proton pump inhibitor (PPI) tests are used to see how well they could diagnose GERD-related chest pain that are not caused by the heart diseases.
Methods: Randomly, 21cases of GERD-related NCCP and 8cases of non-GERD-related NCCP were assigned into two groups of total 29patients with NCCP. General information, esophageal dynamic indices, and the diagnostic effectiveness of PPI in patients from various groups were observed and documented.
Results: The lower esophageal sphincter (LES)pressure at rest was found to be significantly lower in patients with non-cardiac chest pain (NCCP) caused by GERD than in patients with NCCP not caused by GERD. The mean LES resting pressure and mean residual pressure were also lower in the GERD-related NCCP group. Additionally, the maximum residual pressure was lower in the GERD-related NCCP group. These differences between the two groups were statistically significant, with a p-value less than 0.05. The PPI test yielded a sensitivity of 78.95%, a specificity of 83.33%, a positive predictive value (PPV) of 93.75%, and a negative predictive value (NPV) of 55.56% in relation to non-cardiac chest pain (NCCP) associated with gastro esophageal reflux disease (GERD).
Conclusion: In summary, the utilization of high-resolution esophageal manometry (EM) has demonstrated significant diagnostic utility in the context of non-cardiac chest pain (NCCP). The strategic use of antispasmodic medications has the potential to alleviate symptoms experienced by individuals with non-cardiac chest pain (NCCP) and enhance their overall quality of life (QOL). Also, the proton pump inhibitor (PPI) test is widely thought to be the best way to diagnose non-cardiac chest pain (NCCP) caused by gastro-esophageal reflux disease (GERD) in a clinical setting.
Methods: Randomly, 21cases of GERD-related NCCP and 8cases of non-GERD-related NCCP were assigned into two groups of total 29patients with NCCP. General information, esophageal dynamic indices, and the diagnostic effectiveness of PPI in patients from various groups were observed and documented.
Results: The lower esophageal sphincter (LES)pressure at rest was found to be significantly lower in patients with non-cardiac chest pain (NCCP) caused by GERD than in patients with NCCP not caused by GERD. The mean LES resting pressure and mean residual pressure were also lower in the GERD-related NCCP group. Additionally, the maximum residual pressure was lower in the GERD-related NCCP group. These differences between the two groups were statistically significant, with a p-value less than 0.05. The PPI test yielded a sensitivity of 78.95%, a specificity of 83.33%, a positive predictive value (PPV) of 93.75%, and a negative predictive value (NPV) of 55.56% in relation to non-cardiac chest pain (NCCP) associated with gastro esophageal reflux disease (GERD).
Conclusion: In summary, the utilization of high-resolution esophageal manometry (EM) has demonstrated significant diagnostic utility in the context of non-cardiac chest pain (NCCP). The strategic use of antispasmodic medications has the potential to alleviate symptoms experienced by individuals with non-cardiac chest pain (NCCP) and enhance their overall quality of life (QOL). Also, the proton pump inhibitor (PPI) test is widely thought to be the best way to diagnose non-cardiac chest pain (NCCP) caused by gastro-esophageal reflux disease (GERD) in a clinical setting.
References
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7. Choi JK, Shim HI, Shin CM, Yoon H, Park YS, Kim N, Lee DH. [Therapeutic Response to 20 mg of Esomeprazole Twice Daily in Patients with Gastroesophageal Reflux Disease-related Non-cardiac Chest Pain: An Open-Label Randomized Pilot Study]. Korean J Gastroenterol 2020 Jun 25; 75(6): 333-340. Korean. doi: 10.4166/kjg.2020.75.6.333. PMID: 32581204.
8. Ribolsi M, Balestrieri P, Biasutto D, Emerenziani S, Cicala M. Role of Mixed Reflux and Hypomotility with Delayed Reflux Clearance in Patients with Non-cardiac Chest Pain. J Neurogastroenterol Motil 2016 Oct 30; 22(4): 606-612. doi: 10.5056/jnm15182. PMID: 27095707; PMCID: PMC5056569.
9. Chapelle N, Ben Ghezala I, Barkun A, Bardou M. The pharmacotherapeutic management of gastroesophageal reflux disease (GERD). Expert Opin Pharmacother 2021 Feb; 22(2): 219-227. doi: 10.1080/14656566.2020.1817385. Epub 2020 Sep 7. PMID: 32893683.
10. Delshad SD, Almario CV, Chey WD, Spiegel BMR. Prevalence of Gastroesophageal Reflux Disease and Proton Pump Inhibitor-Refractory Symptoms. Gastroenterology 2020 Apr; 158(5): 1250-1261.e2. doi: 10.1053/j.gastro.2019.12.014. Epub 2019 Dec 19. PMID: 31866243; PMCID: PMC7103516.
11. Contaldo M, Lucchese A, Gentile E, Zulli C, Petruzzi M, Lauritano D, Amato MR, Esposito P, Riegler G, Serpico R. Evaluation of the intraepithelial papillary capillary loops in benign and malignant oral lesions by in vivo Virtual Chromoendoscopic Magnification: a preliminary study. Journal of Biological Regulators and Homeostatic Agents 2017; 31(2(S1)): 11-22.
12. Lee L, Ramos-Alvarez I, Ito T, Jensen RT. Insights into Effects/Risks of Chronic Hypergastrinemia and Lifelong PPI Treatment in Man Based on Studies of Patients with Zollinger-Ellison Syndrome. Int J Mol Sci 2019 Oct 16; 20(20): 5128. doi: 10.3390/ijms20205128. PMID: 31623145; PMCID: PMC6829234.
13. Newberry C, Lynch K. The role of diet in the development and management of gastroesophageal reflux disease: why we feel the burn. J Thorac Dis 2019 Aug; 11(Suppl 12): S1594-S1601. doi: 10.21037/jtd.2019.06.42. PMID: 31489226; PMCID: PMC6702398.
14. Zerbib F, Bredenoord AJ, Fass R, Kahrilas PJ, Roman S, Savarino E, Sifrim D, Vaezi M, Yadlapati R, Gyawali CP. ESNM/ANMS consensus paper: Diagnosis and management of refractory gastro-esophageal reflux disease. Neurogastroenterol Motil 2021 Apr; 33(4): e14075. doi: 10.1111/nmo.14075. Epub 2020 Dec 28. PMID: 33368919.
15. Miwa H, Igarashi A, Teng L, Uda A, Deguchi H, Tango T. Systematic review with network meta-analysis: indirect comparison of the efficacy of vonoprazan and proton-pump inhibitors for maintenance treatment of gastroesophageal reflux disease. J Gastroenterol 2019 Aug; 54(8): 718-729. doi: 10.1007/s00535-019-01572-y. Epub 2019 Mar 27. PMID: 30919071; PMCID: PMC6647489.
16. Al-Aly Z, Maddukuri G, Xie Y. Proton Pump Inhibitors and the Kidney: Implications of Current Evidence for Clinical Practice and When and How to Deprescribe. Am J Kidney Dis 2020 Apr; 75(4): 497-507. doi: 10.1053/j.ajkd.2019.07.012. Epub 2019 Oct 10. PMID: 31606235.
17. Savarino V, Marabotto E, Zentilin P, Demarzo MG, de Bortoli N, Savarino E. Pharmacological Management of Gastro-Esophageal Reflux Disease: An Update of the State-of-the-Art. Drug Des Devel Ther 2021 Apr 19; 15: 1609-1621. doi: 10.2147/DDDT.S306371. PMID: 33907381; PMCID: PMC8064680.
18. Wang AF, Li RG, Li R, Hongyan Qin HY. Clinical Efficacy Of Anti-Tumor Decoction Combined With Chemotherapy In The Treatment Of Advanced Oral Cancer And Its Effect On Serum Tumor Markers, T Lymphocyte Subsets And Survival Rates Of Patients. Acta Medica Mediterranea 2021; 37: 2779. DOI: 10.19193/0393-6384_2021_5_428.
19. Sierra-Arango F, Castaño DM, Forero JD, Pérez-Riveros ED, Ardila Duarte G, Botero ML, Cárdenas A, De la Hoz-Valle J. A Randomized Placebo-Controlled N-of-1 Trial: The Effect of Proton Pump Inhibitor in the Management of Gastroesophageal Reflux Disease. Can J Gastroenterol Hepatol 2019 Dec 12; 2019: 3926051. doi: 10.1155/2019/3926051. PMID: 31929980; PMCID: PMC6935808.
20. Rivière P, Vauquelin B, Rolland E, Melchior C, Roman S, Bruley des Varannes S, Mion F, Gourcerol G, Sacher-Huvelin S, Zerbib F. Low FODMAPs diet or usual dietary advice for the treatment of refractory gastroesophageal reflux disease: An open-labeled randomized trial. Neurogastroenterol Motil 2021 Sep; 33(9): e14181. doi: 10.1111/nmo.14181. Epub 2021 May 29. PMID: 34051134.
21. Zhao Y, Ma T, Zou D. Identification of Unique Transcriptomic Signatures and Hub Genes Through RNA Sequencing and Integrated WGCNA and PPI Network Analysis in Nonerosive Reflux Disease. J Inflamm Res 2021 Nov 23; 14: 6143-6156. doi: 10.2147/JIR.S340452. PMID: 34848992; PMCID: PMC8627320.
22. Kröner PT, Cortés P, Lukens FJ. The Medical Management of Gastroesophageal Reflux Disease: A Narrative Review. J Prim Care Community Health 2021 Jan-Dec; 12: 21501327211046736. doi: 10.1177/21501327211046736. PMID: 34581222; PMCID: PMC8481709.
23. Jurkiewicz D, Waśko-Czopnik D, Pietruszewska W, Tarnowski W, Barańska M, Kowalczyk M, Jaworski P. Gastroesophageal reflux disease - from the point of view of a gastroenterologist, otolaryngologist and surgeon. Otolaryngol Pol 2021 Apr 30; 75(2): 42-50. doi: 10.5604/01.3001.0014.8478. PMID: 33949317.
24. Rodríguez de Santiago E, Sanchez-Vegazo CT, Peñas B, Shimamura Y, Tanabe M, Álvarez-Díaz N, Parejo S, Kazuya S, Marcos-Carrasco N, Vazquez-Sequeiros E, Inoue H, Albillos A. Antireflux mucosectomy (ARMS) and antireflux mucosal ablation (ARMA) for gastroesophageal reflux disease: a systematic review and meta-analysis. Endosc Int Open 2021 Nov 12; 9(11): E1740-E1751. doi: 10.1055/a-1552-3239. PMID: 34790538; PMCID: PMC8589565.
25. He J, Yin Y, Tang W, Jiang J, Gu L, Yi J, Yan L, Chen S, Wu Y, Liu X. Objective Outcomes of an Extended Anti-reflux Mucosectomy in the Treatment of PPI-Dependent Gastroesophageal Reflux Disease (with Video). J Gastrointest Surg 2022 Aug; 26(8): 1566-1574. doi: 10.1007/s11605-022-05396-9. Epub 2022 Jul 1. PMID: 35776296.
26. Sumi K, Inoue H, Kobayashi Y, Iwaya Y, Abad MRA, Fujiyoshi Y, Shimamura Y, Ikeda H, Onimaru M. Endoscopic treatment of proton pump inhibitor-refractory gastroesophageal reflux disease with anti-reflux mucosectomy: Experience of 109 cases. Dig Endosc 2021 Mar; 33(3): 347-354. doi: 10.1111/den.13727. Epub 2020 Aug 11. PMID: 32415898.
27. Abdallah J, George N, Yamasaki T, Ganocy S, Fass R. Most Patients With Gastroesophageal Reflux Disease Who Failed Proton Pump Inhibitor Therapy Also Have Functional Esophageal Disorders. Clin Gastroenterol Hepatol 2019 May; 17(6): 1073-1080.e1. doi: 10.1016/j.cgh.2018.06.018. Epub 2018 Jun 18. PMID: 29913281.
28. Zhuang QJ, Tan ND, Chen SF, Zhang MY, Xiao YL. Magnetic sphincter augmentation in treating refractory gastroesophageal reflux disease: A systematic review and meta-analysis. J Dig Dis 2021 Dec; 22(12): 695-705. doi: 10.1111/1751-2980.13063. Epub 2021 Nov 30. PMID: 34693633.
29. Ogawa M, Arihiro S, Matsuhashi N, Joh T, Higuchi K, Iwakiri K, Kamiya T, Manabe N, Isshi K, Nakada T, Hokari A, Saruta M, Oshio A, Haruma K, Nakada K. The early therapeutic response at 2 weeks is a crucial predictor of proton pump inhibitor-refractory gastroesophageal reflux disease. Esophagus. 2021 Apr;18(2):398-406. doi: 10.1007/s10388-020-00792-z. Epub 2020 Nov 2. Erratum in: Esophagus 2021 Jul; 18(3): 711-712. PMID: 33136239.
2. Yadlapati R, Gyawali CP, Pandolfino JE; CGIT GERD Consensus Conference Participants. AGA Clinical Practice Update on the Personalized Approach to the Evaluation and Management of GERD: Expert Review. Clin Gastroenterol Hepatol. 2022 May;20(5):984-994.e1. doi: 10.1016/j.cgh.2022.01.025. Epub 2022 Feb 2. Erratum in: Clin Gastroenterol Hepatol 2022 Sep; 20(9): 2156. PMID: 35123084.
3. Wertli MM, Dangma TD, Müller SE, Gort LM, Klauser BS, Melzer L, Held U, Steurer J, Hasler S, Burgstaller JM. Non-cardiac chest pain patients in the emergency department: Do physicians have a plan how to diagnose and treat them? A retrospective study. PLoS One 2019 Feb 1; 14(2): e0211615. doi: 10.1371/journal.pone.0211615. PMID: 30707725; PMCID: PMC6358153.
4. Mirkeshavarz M, Ganjibakhsh M, Aminishakib P, Farzaneh P, Mahdavi N, Vakhshiteh F, Karimi A, Gohari NS, Kamali F, Kharazifard MJ, Shahzadeh Fazeli SA, Nasimian A. Interleukin-6 secreted by oral cancer- associated fibroblast accelerated VEGF expression in tumor and stroma cells. Cellular and Molecular Biology 2017; 63(10): 131–136. https://doi.org/10.14715/cmb/2017.63.10.21.
5. Frieling T, Bergdoldt G, Allescher HD, Riemann JF. Brustschmerz - nicht immer das Herz! Klinische Bedeutung gastrointestinaler Erkrankungen beim nicht-kardialen Thoraxschmerz [Chest pain - not always the heart! Clinical impact of gastrointestinal diseases in non-cardiac chest pain]. Z Gastroenterol 2015 Feb; 53(2): 120-4. German. doi: 10.1055/s-0034-1385770. Epub 2015 Feb 10. PMID: 25668714.
6. Barret M, Herregods TV, Oors JM, Smout AJ, Bredenoord AJ. Diagnostic yield of 24-hour esophageal manometry in non-cardiac chest pain. Neurogastroenterol Motil 2016 Aug; 28(8): 1186-93. doi: 10.1111/nmo.12818. Epub 2016 Mar 27. PMID: 27018150.
7. Choi JK, Shim HI, Shin CM, Yoon H, Park YS, Kim N, Lee DH. [Therapeutic Response to 20 mg of Esomeprazole Twice Daily in Patients with Gastroesophageal Reflux Disease-related Non-cardiac Chest Pain: An Open-Label Randomized Pilot Study]. Korean J Gastroenterol 2020 Jun 25; 75(6): 333-340. Korean. doi: 10.4166/kjg.2020.75.6.333. PMID: 32581204.
8. Ribolsi M, Balestrieri P, Biasutto D, Emerenziani S, Cicala M. Role of Mixed Reflux and Hypomotility with Delayed Reflux Clearance in Patients with Non-cardiac Chest Pain. J Neurogastroenterol Motil 2016 Oct 30; 22(4): 606-612. doi: 10.5056/jnm15182. PMID: 27095707; PMCID: PMC5056569.
9. Chapelle N, Ben Ghezala I, Barkun A, Bardou M. The pharmacotherapeutic management of gastroesophageal reflux disease (GERD). Expert Opin Pharmacother 2021 Feb; 22(2): 219-227. doi: 10.1080/14656566.2020.1817385. Epub 2020 Sep 7. PMID: 32893683.
10. Delshad SD, Almario CV, Chey WD, Spiegel BMR. Prevalence of Gastroesophageal Reflux Disease and Proton Pump Inhibitor-Refractory Symptoms. Gastroenterology 2020 Apr; 158(5): 1250-1261.e2. doi: 10.1053/j.gastro.2019.12.014. Epub 2019 Dec 19. PMID: 31866243; PMCID: PMC7103516.
11. Contaldo M, Lucchese A, Gentile E, Zulli C, Petruzzi M, Lauritano D, Amato MR, Esposito P, Riegler G, Serpico R. Evaluation of the intraepithelial papillary capillary loops in benign and malignant oral lesions by in vivo Virtual Chromoendoscopic Magnification: a preliminary study. Journal of Biological Regulators and Homeostatic Agents 2017; 31(2(S1)): 11-22.
12. Lee L, Ramos-Alvarez I, Ito T, Jensen RT. Insights into Effects/Risks of Chronic Hypergastrinemia and Lifelong PPI Treatment in Man Based on Studies of Patients with Zollinger-Ellison Syndrome. Int J Mol Sci 2019 Oct 16; 20(20): 5128. doi: 10.3390/ijms20205128. PMID: 31623145; PMCID: PMC6829234.
13. Newberry C, Lynch K. The role of diet in the development and management of gastroesophageal reflux disease: why we feel the burn. J Thorac Dis 2019 Aug; 11(Suppl 12): S1594-S1601. doi: 10.21037/jtd.2019.06.42. PMID: 31489226; PMCID: PMC6702398.
14. Zerbib F, Bredenoord AJ, Fass R, Kahrilas PJ, Roman S, Savarino E, Sifrim D, Vaezi M, Yadlapati R, Gyawali CP. ESNM/ANMS consensus paper: Diagnosis and management of refractory gastro-esophageal reflux disease. Neurogastroenterol Motil 2021 Apr; 33(4): e14075. doi: 10.1111/nmo.14075. Epub 2020 Dec 28. PMID: 33368919.
15. Miwa H, Igarashi A, Teng L, Uda A, Deguchi H, Tango T. Systematic review with network meta-analysis: indirect comparison of the efficacy of vonoprazan and proton-pump inhibitors for maintenance treatment of gastroesophageal reflux disease. J Gastroenterol 2019 Aug; 54(8): 718-729. doi: 10.1007/s00535-019-01572-y. Epub 2019 Mar 27. PMID: 30919071; PMCID: PMC6647489.
16. Al-Aly Z, Maddukuri G, Xie Y. Proton Pump Inhibitors and the Kidney: Implications of Current Evidence for Clinical Practice and When and How to Deprescribe. Am J Kidney Dis 2020 Apr; 75(4): 497-507. doi: 10.1053/j.ajkd.2019.07.012. Epub 2019 Oct 10. PMID: 31606235.
17. Savarino V, Marabotto E, Zentilin P, Demarzo MG, de Bortoli N, Savarino E. Pharmacological Management of Gastro-Esophageal Reflux Disease: An Update of the State-of-the-Art. Drug Des Devel Ther 2021 Apr 19; 15: 1609-1621. doi: 10.2147/DDDT.S306371. PMID: 33907381; PMCID: PMC8064680.
18. Wang AF, Li RG, Li R, Hongyan Qin HY. Clinical Efficacy Of Anti-Tumor Decoction Combined With Chemotherapy In The Treatment Of Advanced Oral Cancer And Its Effect On Serum Tumor Markers, T Lymphocyte Subsets And Survival Rates Of Patients. Acta Medica Mediterranea 2021; 37: 2779. DOI: 10.19193/0393-6384_2021_5_428.
19. Sierra-Arango F, Castaño DM, Forero JD, Pérez-Riveros ED, Ardila Duarte G, Botero ML, Cárdenas A, De la Hoz-Valle J. A Randomized Placebo-Controlled N-of-1 Trial: The Effect of Proton Pump Inhibitor in the Management of Gastroesophageal Reflux Disease. Can J Gastroenterol Hepatol 2019 Dec 12; 2019: 3926051. doi: 10.1155/2019/3926051. PMID: 31929980; PMCID: PMC6935808.
20. Rivière P, Vauquelin B, Rolland E, Melchior C, Roman S, Bruley des Varannes S, Mion F, Gourcerol G, Sacher-Huvelin S, Zerbib F. Low FODMAPs diet or usual dietary advice for the treatment of refractory gastroesophageal reflux disease: An open-labeled randomized trial. Neurogastroenterol Motil 2021 Sep; 33(9): e14181. doi: 10.1111/nmo.14181. Epub 2021 May 29. PMID: 34051134.
21. Zhao Y, Ma T, Zou D. Identification of Unique Transcriptomic Signatures and Hub Genes Through RNA Sequencing and Integrated WGCNA and PPI Network Analysis in Nonerosive Reflux Disease. J Inflamm Res 2021 Nov 23; 14: 6143-6156. doi: 10.2147/JIR.S340452. PMID: 34848992; PMCID: PMC8627320.
22. Kröner PT, Cortés P, Lukens FJ. The Medical Management of Gastroesophageal Reflux Disease: A Narrative Review. J Prim Care Community Health 2021 Jan-Dec; 12: 21501327211046736. doi: 10.1177/21501327211046736. PMID: 34581222; PMCID: PMC8481709.
23. Jurkiewicz D, Waśko-Czopnik D, Pietruszewska W, Tarnowski W, Barańska M, Kowalczyk M, Jaworski P. Gastroesophageal reflux disease - from the point of view of a gastroenterologist, otolaryngologist and surgeon. Otolaryngol Pol 2021 Apr 30; 75(2): 42-50. doi: 10.5604/01.3001.0014.8478. PMID: 33949317.
24. Rodríguez de Santiago E, Sanchez-Vegazo CT, Peñas B, Shimamura Y, Tanabe M, Álvarez-Díaz N, Parejo S, Kazuya S, Marcos-Carrasco N, Vazquez-Sequeiros E, Inoue H, Albillos A. Antireflux mucosectomy (ARMS) and antireflux mucosal ablation (ARMA) for gastroesophageal reflux disease: a systematic review and meta-analysis. Endosc Int Open 2021 Nov 12; 9(11): E1740-E1751. doi: 10.1055/a-1552-3239. PMID: 34790538; PMCID: PMC8589565.
25. He J, Yin Y, Tang W, Jiang J, Gu L, Yi J, Yan L, Chen S, Wu Y, Liu X. Objective Outcomes of an Extended Anti-reflux Mucosectomy in the Treatment of PPI-Dependent Gastroesophageal Reflux Disease (with Video). J Gastrointest Surg 2022 Aug; 26(8): 1566-1574. doi: 10.1007/s11605-022-05396-9. Epub 2022 Jul 1. PMID: 35776296.
26. Sumi K, Inoue H, Kobayashi Y, Iwaya Y, Abad MRA, Fujiyoshi Y, Shimamura Y, Ikeda H, Onimaru M. Endoscopic treatment of proton pump inhibitor-refractory gastroesophageal reflux disease with anti-reflux mucosectomy: Experience of 109 cases. Dig Endosc 2021 Mar; 33(3): 347-354. doi: 10.1111/den.13727. Epub 2020 Aug 11. PMID: 32415898.
27. Abdallah J, George N, Yamasaki T, Ganocy S, Fass R. Most Patients With Gastroesophageal Reflux Disease Who Failed Proton Pump Inhibitor Therapy Also Have Functional Esophageal Disorders. Clin Gastroenterol Hepatol 2019 May; 17(6): 1073-1080.e1. doi: 10.1016/j.cgh.2018.06.018. Epub 2018 Jun 18. PMID: 29913281.
28. Zhuang QJ, Tan ND, Chen SF, Zhang MY, Xiao YL. Magnetic sphincter augmentation in treating refractory gastroesophageal reflux disease: A systematic review and meta-analysis. J Dig Dis 2021 Dec; 22(12): 695-705. doi: 10.1111/1751-2980.13063. Epub 2021 Nov 30. PMID: 34693633.
29. Ogawa M, Arihiro S, Matsuhashi N, Joh T, Higuchi K, Iwakiri K, Kamiya T, Manabe N, Isshi K, Nakada T, Hokari A, Saruta M, Oshio A, Haruma K, Nakada K. The early therapeutic response at 2 weeks is a crucial predictor of proton pump inhibitor-refractory gastroesophageal reflux disease. Esophagus. 2021 Apr;18(2):398-406. doi: 10.1007/s10388-020-00792-z. Epub 2020 Nov 2. Erratum in: Esophagus 2021 Jul; 18(3): 711-712. PMID: 33136239.
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Nov 11, 2023
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Nisha Hamid Awan, Emama Arshad Abbasi, Javeria Qadeer Abbasi, Maham Tariq, Muhammad Amir, Soffia Khursheed, Amna Akbar, Sabahat Tasneem, Sarosh Khan Jadoon, & Raja Muhammad Ijaz Khan. (2023). ESOPHAGEAL MANOMETRY COMBINED WITH PROTON PUMP INHIBITOR TEST APPLIED IN THE DIAGNOSIS OF NON-CARDIAC CHEST PAIN ASSOCIATED WITH GASTRO-ESOPHAGEAL REFLUX DISEASE. Journal of Population Therapeutics and Clinical Pharmacology, 30(18), 2017–2028. https://doi.org/10.53555/jptcp.v30i18.3362
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Author Biographies
Nisha Hamid Awan
Resident Medicine, Combined Military Hospital, Muzaffarabad, AJK, Pakistan
Emama Arshad Abbasi
Houseofficer, Combined Military Hospital, Muzaffarabad, AJK, Pakistan
Javeria Qadeer Abbasi
Post graduate trainee medicine, Combined Military Hospital, Muzaffarabad, AJK
Maham Tariq
House officer, Gujranwala, Teaching Hospital, Gujranwala
Muhammad Amir
Medical Officer, Midland Doctors Medical Institute, Muzaffarabad, Pakistan, AJK
Soffia Khursheed
Assistant Professor Histopathology, Pakistan Institute of Medical Science, Islamabad, Pakistan
Amna Akbar
Medical Officer, District Headquarter Hospital Jhelum Valley, AJK, Pakistan
Sabahat Tasneem
Public Health Professional (MSPH), Health Services Academy, Islamabad, Pakistan
Sarosh Khan Jadoon
Resident Surgeon, Combined Military Hospital, Muzaffarabad, AJK, Pakistan
Raja Muhammad Ijaz Khan
Professor of Surgery AJK Medical College, Muzaffarabad, AJK, Consultant Surgeon, Combined Military Hospital, Muzaffarabad, AJK, Pakistan